BACKGROUND OF THE INVENTION
1. Field of the Invention
[0001] The present invention relates to a medical system provided with a treatment instrument
that performs treatment on living body tissue, and more particularly, to a medical
system provided with an endoscope to be inserted into a body cavity and various treatment
instruments to be used in combination with the endoscope.
2. Description of the Related Art
[0002] As is generally known, endoscopes are widely used in the industrial field and the
field of medicine. With endoscopes that are medical apparatuses used in the field
of medicine, observations are made by inserting an insertion portion into a body cavity
of a subject being tested.
[0003] In addition, with such an endoscope, various treatments may be performed by introducing
treatment instruments via a treatment instrument insertion channel provided to the
insertion portion. When performing treatment on a body cavity tissue using a treatment
instrument, the operator introduces the treatment instrument into the body cavity
via a treatment instrument insertion channel of the endoscope.
[0004] Normally, the treatment instrument is manually inserted into and pulled out by the
operator from the treatment instrument insertion channel of the endoscope. In this
light, for example, Japanese Patent Laid-Open No.
S57-190541, Japanese Patent Laid-Open No.
2000-207, and Japanese Patent Laid-Open No.
2007-117394 disclose an apparatus capable of electrically operating a treatment instrument and
which automatically inserts into and pulls out the treatment instrument from a treatment
instrument insertion channel of an endoscope for the purpose of improving handleability
of the treatment instrument.
[0005] A conventional apparatus includes: a treatment instrument insert/remove mode in which
the treatment instrument is inserted to the treatment instrument insertion channel
at high speed or pulled out from the treatment instrument insertion channel at high
speed; and a treatment instrument advance/retreat mode in which treatment operations
are facilitated by advancing/retreating the treatment instrument at low-speed in a
state where the treatment instrument protrudes from the distal end of the endoscope.
Switching between these modes is either performed manually using switching means provided
separately, or automatically through the detection of the insertion length of the
treatment instrument.
[0006] However, the manual switching between those modes as in the conventional apparatus
requires the operator to operate a switch other than a sheath advancing/retreating
switch when operating the treatment instrument. This problematically results in complicated
operation and the operator forgetting to switch the modes.
[0007] On the other hand, when the conventional apparatus automatically switches between
the modes through detecting the insertion length of the treatment instrument, there
may occur a sliding between the sheath of the treatment instrument and a roller as
moving means for feeding/retracting the sheath, or a mismatch between the insertion
length of the sheath inserted in the endoscope insertion portion and the detection
amount of the sheath if the insertion portion is complicatedly bent. This may problematically
result in the incapability of the conventional apparatus to switch the modes at a
user-intended position (point). The conventional apparatus has another problem of
the incapability to switch the modes at an arbitrary position (point) other than an
initial set position.
[0008] The present invention has been made in view of the above circumstances, and an object
of the invention is to provide a medical system with a good operability that allows
for sure and easy switching of the moving speed of the treatment instrument during
operation thereof.
SUMMARY OF THE INVENTION
[0009] A medical system according to the present invention includes: a medical instrument
having a treatment portion for performing treatment operations on living body tissue;
a treatment portion displacement mechanism for displacing the position of the treatment
portion of the medical instrument; a treatment detection portion that detects whether
the treatment portion is in a treatment state or a non-treatment state; and a control
portion that controls displacement of the treatment portion by controlling the treatment
portion displacement mechanism according to detection results from the treatment detection
portion.
[0010] The above and other objects, features and advantages of the invention will become
more clearly understood from the following description referring to the accompanying
drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
[0011]
Fig. 1 is a diagram showing an overall configuration of an endoscopic system according
to a first embodiment of the present invention to which a high-frequency knife has
been set;
Fig. 2 is a diagram including a block display of a configuration of the endoscopic
system shown in Fig. 1;
Fig. 3 is a flowchart illustrating control performed by a control apparatus of the
endoscopic system shown in Fig. 1;
Fig. 4 is a diagram including a block display of a configuration of an endoscopic
system according to a first modification of the first embodiment to which a high-frequency
hemostatic forceps has been set;
Fig. 5 is a flowchart illustrating control performed by a control apparatus of the
endoscopic system shown in Fig. 4;
Fig. 6 is a diagram including a block display of a configuration of an endoscopic
system according to a second modification of the first embodiment to which a high-frequency
snare has been set;
Fig. 7 is a cross sectional diagram showing a configuration of a high-frequency snare;
Fig. 8 is a flowchart illustrating control performed by a control apparatus of the
endoscopic system shown in Fig. 6;
Fig. 9 is a diagram showing a state where a treatment portion of a high-frequency
snare is constricting a polyp;
Fig. 10 is a cross sectional diagram showing a pressure sensor allocated on a sheath
of a high-frequency snare;
Fig. 11 is a flowchart illustrating control performed by a control apparatus of an
endoscopic system according to a third modification of the first embodiment;
Fig. 12 is a diagram including a block display of a configuration of an endoscopic
system according to a second embodiment of the present invention to which grasping
forceps have been set;
Fig. 13 is a flowchart illustrating control performed by a control apparatus of the
endoscopic system shown in Fig. 12;
Fig. 14 is a diagram including a block display of a configuration of an endoscopic
system according to a third embodiment of the present invention to which a rotating
clip apparatus has been set;
Fig. 15 is a flowchart illustrating control performed by a control apparatus of the
endoscopic system shown in Fig. 14;
Fig. 16 is a perspective view according to a fourth embodiment of the present invention
showing a state where grasping forceps project from the distal end portion of an endoscope;
Fig. 17 is a diagram showing a display on a monitor screen corresponding to Fig. 16;
Fig. 18 is a flowchart illustrating control performed by a control apparatus of an
endoscopic system;
Fig. 19 is a cross sectional diagram according to a fifth embodiment of the present
invention showing a state where grasping forceps are housed in a treatment instrument
insertion channel;
Fig. 20 is a cross sectional diagram showing a distal end portion of an endoscope
having an optical sensor and showing a state where grasping forceps project from the
distal end portion;
Fig. 21 is a diagram according to a sixth embodiment of the present invention showing
a configuration of a distal end portion of grasping forceps that are a treatment instrument
having a light reflective portion at a rear end portion of a treatment portion thereof;
Fig. 22 is a cross sectional diagram showing a distal end portion of an endoscope
having an optical sensor and which shows a state where grasping forceps project from
the distal end portion;
Fig. 23 shows a modification and is a cross sectional diagram showing a distal end
portion of an endoscope having an optical sensor and which shows a state where grasping
forceps project from the distal end portion;
Fig. 24 is a flowchart illustrating control performed by a control apparatus of an
endoscopic system;
Fig. 25 is a diagram showing a treatment portion of biopsy forceps projecting from
the distal end portion of an endoscope according to a seventh embodiment of the present
invention in a state prior to the removal of living mucosa;
Fig. 26 is a diagram showing a state after the removal of living mucosa by a treatment
portion 41 of biopsy forceps;
Fig. 27 is a flowchart illustrating control performed by a control apparatus of an
endoscopic system;
Fig. 28 is a diagram showing an overall configuration of an endoscopic system according
to an eighth embodiment of the present invention to which a high-frequency knife has
been set;
Fig. 29 is a flowchart illustrating control performed by a control apparatus of the
endoscopic system shown in Fig. 28;
Fig. 30 is a perspective view showing a controller of an endoscopic system 1 and a
control apparatus according to a first reference example;
Fig. 31 is a cross sectional diagram showing a state where a controller is grasped
by an operator according to a second reference example;
Fig. 32 is a cross sectional diagram showing a controller having a limit switch according
to a third reference example;
Fig. 33 is a cross sectional diagram showing a state where an insertion portion is
inserted into the controller shown in Fig. 32;
Fig. 34 is a perspective view showing a state where a slider of a treatment instrument
is mounted to a retaining portion of a treatment instrument electrical operation apparatus
having a limit switch according to a fourth reference example;
Fig. 35 is a cross sectional diagram showing a retaining portion in a state where
a slider is not mounted;
Fig. 36 is a cross sectional diagram for describing a state where a slider is mounted;
Fig. 37 is a cross sectional diagram showing a state where a slider is mounted to
a retaining portion; and
Fig. 38 is a configuration diagram showing a controller, a treatment instrument electrical
operation apparatus and a treatment instrument changer according to a fifth reference
example.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0012] Embodiments of the present invention will be described below with reference to the
drawings.
(First Embodiment)
[0013] First, a first embodiment of the present invention will be described below with reference
to Figs. 1 to 3.
[0014] Figs. 1 to 3 are drawings according to the first embodiment of the present invention,
in which: Fig. 1 is a diagram showing an overall configuration of an endoscopic system
to which a high-frequency knife has been set; Fig. 2 is a diagram including a block
display of a configuration of the endoscopic system shown in Fig. 1; and Fig. 3 is
a flowchart illustrating control performed by a control apparatus of the endoscopic
system shown in Fig. 1.
[0015] As shown in Fig. 1, an endoscopic system 1 that is a medical system according to
the present embodiment primarily comprises: an endoscope 10; a control apparatus 20
that also functions as a light source apparatus and a video processor; a controller
30 that is an operation instruction apparatus; a treatment instrument 40 that is an
medical instrument provided with a treatment portion 41 that performs predetermined
treatment on body cavity tissue; a treatment instrument electrical operation apparatus
50 that is a treatment portion operation apparatus that electrically operates the
treatment portion 41; a treatment instrument insertion portion electrical advance/retreat
apparatus (hereinafter simply described as the electrical advance/retreat apparatus)
60 that is a treatment portion displacement mechanism for advancing and retreating
a sheath 42 of the treatment instrument 40; and a high frequency power supply 70 that
applies high-frequency current to the treatment instrument 40.
[0016] The endoscope 10 shown in Fig. 1 is configured so as to comprise: an endoscope insertion
portion (hereinafter abbreviated to the insertion portion) 14; an operation portion
15 to which the insertion portion 14 is connected; and a universal cord 15a detachable
to the control apparatus 20.
[0017] The operation portion 15 of the endoscope 10 also functions as a grasping portion
to an operator, and is provided on a proximal end-side of the insertion portion 14.
The universal code 15a projects from a lateral side of the operation portion 15, and
a connector portion of a proximal end thereof is detachably connected to the control
apparatus 20.
[0018] The insertion portion 14 of the endoscope 10 is configured by consecutively installing,
in order from the distal end side: a rigid distal end portion 11; a bendable bending
portion 12; and a flexible tube portion 13 that is flexible. A distal end aperture
11a is provided at the distal end portion 11.
[0019] A bend preventing portion 18 to which is connected the proximal end of the flexible
tube portion 13 is provided at the operation portion 15 of the endoscope 10. Provided
at the operation portion 15 are: two bending knobs 16 for performing bend operations
of the bending portion 12; function switches 17 including an air and water supply
button for supplying air and water and a suction button for performing suction; and
various switches for performing control on endoscopic images obtained through image
pickup devices provided at the distal end portion 11, and the like.
[0020] Moreover, disposed at the insertion portion 14 of the endoscope 10 is a treatment
instrument insertion channel 14a that opens at a treatment instrument insertion hole
19 provided on the bend preventing portion 18 and which communicates with the distal
end aperture 11 a.
[0021] The controller 30 shown in Fig. 1 has an approximately columnar shape. The controller
30 comprises: a rigid main body portion 31; and a grip body 32 consecutively installed
to the main body portion 31 and which is, for example, an elastic member. In addition,
a signal cable 21 projects from a proximal end face-side of the grip body 32. The
proximal end-side of the signal cable 21 is detachably electrically connected to the
control apparatus 20.
[0022] An operation instruction portion 33 is provided on a lateral peripheral face of the
main body portion 31. The operation instruction portion 33 is provided with an operation
lever 34 that is, for instance, of the joystick type. A tilt operation of the operation
lever 34 by the operator to the distal end side causes an instruction signal for advancing
the sheath 42 of the treatment instrument 40, to be described later, to be outputted
from the operation instruction portion 33 to the control apparatus 20. A tilt operation
of the operation lever 34 to the proximal end side causes an instruction signal for
retreating the sheath 42 of the treatment instrument 40, to be described later, to
be outputted from the operation instruction portion 33 to the control apparatus 20.
[0023] In addition, the operation instruction portion 33 is provided with a switch, not
shown, for turning ON/OFF the high frequency power supply 70 that applies a high frequency
to the treatment instrument 40 that performs treatment using high frequency.
[0024] Furthermore, the control apparatus 20 shown in Fig. 1 is provided with: a lamp (not
shown) that supplies illumination; a signal processing circuit (not shown), and the
like. The signal processing circuit performs: processing for generating a drive signal
for driving an image pickup device (not shown) such as a CCD provided at the distal
end portion of the endoscope; processing for generating a video signal from an electric
signal transmitted from the image pickup device, and the like. A display apparatus
such as a liquid crystal display (not shown) that displays endoscopic images is connected
to the control apparatus 20.
[0025] In the present embodiment, the treatment instrument 40 shown in Fig. 1 is, for instance,
a high-frequency knife (which hereinafter shall be described as the high-frequency
knife 40 in the present embodiment), and is provided with the above-mentioned sheath
42 that is a flexible tube body having predetermined resilience.
[0026] The sheath 42 is provided at a distal end portion thereof with a treatment portion
41 that is, in this case, an electrical scalpel having a globular distal end insulated
chip. In the present embodiment, the treatment portion 41 is electrically connected
to a high-frequency power transmission cable, not shown, that is inserted to the sheath
42 and which transmits high frequency outputted from the high frequency power supply
70.
[0027] As shown in Fig. 2, a handle portion 44 of the high-frequency knife 40 comprises:
a finger grip ring 45 and a slider 46. The finger grip ring 45 has a hole portion
in which, for instance, a thumb of the operator is placed. The slider 46 is provided
with a pair of flanges on which, during general use, a middle finger and a ring finger
of the operator are placed. Moreover, the handle portion 44 is provided with a connector
portion 44a for establishing electrical connection to the high frequency power supply
70 via the high-frequency cable 71.
[0028] It should be noted that the slider 46 of the high-frequency knife 40 is designed
so that the operator may position his/her finger on the slider 46 for easy grasping,
and in other treatment instruments to be described later, becomes operation means
for operating the treatment portion 41. In other words, with the high-frequency knife
40 according to the present embodiment, the slider 46 is provided for easier grasping
by the operator, and not necessarily for operating the treatment portion 41.
[0029] The electrical advance/retreat apparatus 60 shown in Fig. 2 is detachably provided
at the treatment instrument insertion hole 19 (refer to Fig. 1) of the endoscope.
The electrical advance/retreat apparatus 60 is electrically connected to the control
apparatus 20 by an electric cable 24 having a signal line inserted therein. The electrical
advance/retreat apparatus 60 advances or retreats the sheath 42 of the high-frequency
knife 40 based on operations of the operation lever 34 (refer to Fig. 1) of the controller
30.
[0030] The electrical advance/retreat apparatus 60 includes two rotatable rollers 61 inside
a chassis thereof. These two rollers 61 are respectively configured of elastic resin
members, whereby one of the rollers 61 is driven by a motor, not shown, that is a
driving source.
[0031] In other words, the sheath 42 of the high-frequency knife 40 is disposed between
the two rollers 61. Accordingly, the exterior faces of the sheath 42 are pressed and
held between the two rollers 61.
[0032] In addition, the other roller 61 that is rotated by a motor (not shown) that is a
driving source and which is disposed within the electrical advance/retreat apparatus
60 advances/retreats the sheath 42 along a rotating direction by means of friction
caused by pressing.
[0033] In other words, by driving the motor in a state where the sheath 42 is held between
the two rollers 61, the sheath 42 that is held between the two rollers 61 is displaced
in accordance with the rotation of one of the rollers 61. Drive-control of the rotating
direction of the motor inside the electrical advance/retreat apparatus 60 advances
or retreats the sheath 42 inside the treatment instrument insertion channel 14a of
the endoscope 10.
[0034] In addition, the drive control of the motor of the electrical advance/retreat apparatus
60 is performed by the control apparatus 20 based on the operations of the operation
lever 34 of the controller 30. The respective rollers 61 are rotatably supported by
a rotating shaft securely installed on the chassis or the motor shaft of the motor
so that the respective roller faces are spaced at a predetermined interval.
[0035] Furthermore, a rotation detection sensor 62 that is a detection portion that detects
the revolutions of the roller 61 is built into the electrical advance/retreat apparatus
60. The detected value of the rotation detection sensor 62 is outputted to the control
apparatus 20 via the electric cable 24. In other words, the control apparatus 20 calculates
the displacement (amount of projection) of the sheath 42 of the high-frequency knife
40 based on the detected value from the rotation detection sensor 62. Moreover, the
sensor for detecting a displacement (amount of projection) of the sheath 42 of the
high-frequency knife 40 need not be limited to the rotation detection sensor 62 that
detects revolution of the roller 61. For example, an optical sensor may be used which
counts indexes provided at regular intervals on the sheath 42, whereby the displacement
(amount of projection) of the sheath 42 of the high-frequency knife 40 is calculated
based on the detected results.
[0036] The electrical operation apparatus 50 shown in Figs. 1 and 2 has a base body 51.
The base body 51 comprises: a ring holding portion 52; a retaining box 53; and a motor
56 having a gear 56a that is a spur gear.
[0037] The retaining box 53 is securely installed on the base body 51 via a leg portion.
A rack 54 forming a linear tooth profile is rectilinearly retained by the retaining
box 53 so as to be advanceable and retreatable. A pinion gear 53a that meshes with
the linear tooth profile of the rack 54 is arranged in the retaining box 53.
[0038] The pinion gear 53a is securely installed on the motor shaft of a motor, not shown.
In other words, the motor is rotated in a state where the pinion gear 53a meshes with
the linear tooth profile provided on the rack 54. This causes the pinion gear 53 a
securely installed on the motor shaft to rotate, thereby advancing/retreating the
rack 54.
[0039] One end of the composite cable 23 is connected to the retaining box 53, while the
other end of the composite cable 23 is detachably electrically connected to the control
apparatus 20.
[0040] In addition, a slider holding portion 55 having a retaining portion 55a is fixed
by a screw to an end portion of the rack 54. The retaining portion 55a of the slider
holding portion 55 holds a slider 46 provided on the handle portion 44 of the high-frequency
knife 40. More specifically, the retaining portion 55a performs retention so as to
hold a body portion between a pair of flanges provided on the slider 46.
[0041] Moreover, although unused in the present invention, drive instructions to the motor
inside the retaining box 53 are performed by leftward or rightward tilt operations
of the operation lever 34 of the controller 30. As an example, tilting the operation
lever 34 rightwards while facing the front of the controller 30 causes the slider
46 to move in a direction in which the rack 54 pushes out forward the operation wire
for operating the treatment portion 41 which is used for other treatment instruments
40 from the retaining box 53. Conversely, tilting the operation lever 34 leftwards
while facing the front causes the slider 46 to move in a direction in which the rack
54 pushes out the operation wire backwards from the retaining box 53.
[0042] In addition, a slide detection sensor 53b that detects advance/retreat displacement
of the rack 54 to detect displacement of the slider 46 is provided in the retaining
box 53. The detected value that is detected by the slide detection sensor 53b is outputted
to the control apparatus 20 via the composite cable 23.
[0043] Moreover, a hole portion of the finger grip ring 45 provided on the handle portion
44 of the high-frequency knife 40 is inserted to and arranged at the ring holding
portion 52. As a result, the handle portion 44 of the high-frequency knife 40 is integrally
securely retained by the electrical operation apparatus 50.
[0044] At this point, the handle portion 44 is retained and fixed by a treatment instrument
fixing portion 51a securely installed on a front face of the base body 51. In addition,
as shown in Fig. 2, the handle portion 44 of the high-frequency knife 40 is disposed
parallel to and separated from the base body 51 by a predetermined distance by the
treatment instrument fixing portion 51a.
[0045] A gear 56a is provided on the motor shaft of the motor 56 provided on a rear face
side of the base body 51. The gear 56a is provided so as to slightly protrude to the
front face side of the base body 51 from a hole portion provided on the base body
51. Moreover, in the present embodiment, the motor 56 is not driven and is instead
used to rotate the treatment portions 41 of other treatment instruments 40 around
a shaft.
[0046] In addition, the control apparatus 20 of the present embodiment is provided with
an endoscope ID read sensor 27 in the connector 25 which, when the connector 25 of
the universal cord 15a of the endoscope 10 is connected thereto, reads endoscope information
and which, in this case, is a read portion of RFID (Radio Frequency Identification).
[0047] The endoscope ID read sensor 27 reads model information of the connected endoscope
10, the length of the insertion portion 14, the channel length of the treatment instrument
insertion channel 14a disposed in the insertion portion 14, and the like from an endoscope
ID internal IC chip 26 built into the connector 25 of the universal cord 15a.
[0048] Furthermore, the ring holding portion 52 of the electrical operation apparatus 50
is provided with a treatment instrument ID read sensor 52a which, when the finger
grip ring 45 is inserted into and disposed in a predetermined state on the ring holding
portion 52, reads treatment instrument information and which, in this case, is a read
portion of RFID (Radio Frequency Identification).
[0049] This treatment instrument ID read sensor 52a reads model information of the disposed
high-frequency knife 40, the length of the sheath 42 and the like from a treatment
instrument ID internal IC chip 49 that is an integrated circuit and the like built
into the finger grip ring 45 of the high-frequency knife 40. In addition, information
which, in this case, is model information of the high-frequency knife 40 and the like
that is read by the treatment instrument ID read sensor 52a is outputted to the control
apparatus 20 via the composite cable 23.
[0050] In addition, the electrical operation apparatus 50 performs electrical exchange with
the control apparatus 20 via the composite cable 23. In other words, the composite
cable 23 supplies to and receives from the control apparatus 20: a motor drive current
inside the retaining box 53 of the electrical operation apparatus 50; a drive current
of the motor 56; a model information signal from the treatment instrument ID read
sensor 52a; and a detected value from the slide detection sensor 53b.
[0051] Moreover, provided within the control apparatus 20 are a treatment detection portion
20a, a control portion 20b and a treatment storage portion 20c which are respectively
electrically connected.
[0052] The treatment detection portion 20a is a sensor that detects output of drive signals
to the electrical operation apparatus 50, the electrical advance/retreat apparatus
60 and the high frequency power supply 70, and also detects input of detection signals
from various sensors. In addition, the control portion 20b is a CPU that performs
control of the control apparatus 20. Furthermore, the treatment storage portion 20c
is a memory that stores drive histories of the electrical operation apparatus 50,
the electrical advance/retreat apparatus 60 and the high frequency power supply 70
that electrically perform treatment operations of the various treatment instruments.
[0053] The high frequency power supply 70 is connected to a communication cable 22 that
is electrically connected to the control apparatus 20 and a high-frequency cable 71
connected to a connector portion 44a of the high-frequency knife 40. When a switch
(not shown) of the controller 30 is turned on, the high frequency power supply 70
applies high frequency to the high-frequency knife 40 via the control apparatus 20.
[0054] When advancing/retreating the high-frequency knife 40, the endoscopic system 1 according
to the present embodiment configured as described above is arranged to perform advance/retreat
control of the sheath 42 in accordance with the treatment state where high frequency
is applied to the treatment portion 41.
[0055] In addition, based on an inputted control table, the control apparatus 20 performs
control according to the routine of the flowchart shown in Fig. 3. More specifically,
in a state where the high-frequency knife 40 is not yet inserted into the treatment
instrument insertion channel 14a of the endoscope 10, the endoscopic system 1 is first
set to a state where various devices are electrically connected as shown in Figs.
1 and 2.
[0056] First, when introducing the high-frequency knife 40 to the treatment instrument insertion
channel 14a of the endoscope 10, the operation lever 34 of the controller 30 is tilt-operated
in a forward direction. In response, the control apparatus 20 drives the electrical
advance/retreat apparatus 60. Then, the operator sends in the sheath 42 of the high-frequency
knife 40 into the treatment instrument insertion channel 14a of the endoscope 10 by
means of the two rollers 61 that hold the sheath 42 therebetween.
[0057] At this point, a drive instruction signal from the operation lever 34 of the controller
30 acts as a trigger and causes the control apparatus 20 to perform control based
on the routine (steps) of the flowchart shown in Fig. 3.
[0058] First, as shown in Fig. 3, the control apparatus 20 reads treatment instrument information
of the high-frequency knife 40 inputted from the treatment instrument ID read sensor
52a and stored in the treatment instrument ID internal IC chip 49 at the treatment
detection portion 20a. The treatment instrument information is inputted from the treatment
detection portion 20a to the control portion 20b (S1). At this point, in the case
where the treatment instrument is the high-frequency knife 40, the control apparatus
20 performs control in accordance with the respective steps of the flowchart shown
in Fig. 3.
[0059] Moreover, in the present embodiment, while the control apparatus 20 is configured
to detect a treatment instrument set to the electrical advance/retreat apparatus 60,
the control apparatus 20 is not limited to this configuration. Instead, the present
invention may be arranged so that the user arbitrarily inputs the treatment instrument
to be used to the control apparatus 20.
[0060] Then, the control portion 20b of the control apparatus 20 judges whether the high
frequency power supply 70 has been energized (S2). At this point, when the high frequency
power supply 70 is in an OFF state, the control portion 20b switches to the normal
mode (S3).
[0061] In this case, the normal mode refers to a normal advance/retreat mode in which the
sheath 42 of the high-frequency knife 40 advances/retreats at a preset, predetermined
speed. In other words, a state where high-frequency is not applied to the high-frequency
knife 40 is a state where only an operation to advance/retreat the sheath 42 of the
high-frequency knife 40 is performed.
[0062] On the other hand, when the high frequency power supply 70 is in an ON state in step
S2, the control portion 20b switches to low-speed mode (S4). In this case, low-speed
mode refers to a low-speed advance/retreat mode in which the sheath 42 of the high-frequency
knife 40 advances/retreats at a preset, predetermined speed that is slower than the
normal advance/retreat mode.
[0063] In other words, when an ON signal is inputted from the switch of the controller 30,
the control portion 20b drives the high frequency power supply 70 so as to enable
dissection of living body tissue at a high frequency by the treatment portion 41 of
the high-frequency knife 40. In this state where an ON signal is inputted from the
switch of the controller 30, the control portion 20b switches to the low-speed mode
in step S4.
[0064] Next, in accordance with each switched mode, the control portion 20b drives the electrical
advance/retreat apparatus 60 that is an actuator (S5). More specifically, when a transition
is made to step S3, the control portion 20b switches to the normal mode and drives
the electrical advance/retreat apparatus 60 in correspondence to a predetermined speed
at which the sheath 42 of the high-frequency knife 40 advances/retreats. On the other
hand, when a transition is made to step S4, the control portion 20b switches to low-speed
mode and drives the electrical advance/retreat apparatus 60 in correspondence to a
predetermined speed that is slower than the normal mode at which the sheath 42 of
the high-frequency knife 40 advances/retreats.
[0065] In other words, the control portion 20b variably outputs voltage to the motor that
rotationally drives the roller 61 of the electrical advance/retreat apparatus 60 according
to preset rotary speeds of the respective modes. As a result, the advance/retreat
speed of the sheath 42 of the high-frequency knife 40 varies according to the ON/OFF
state of the high frequency power supply 70.
[0066] To elaborate, during a simple advance/retreat operation of the sheath 42 in a non-treatment
state where high frequency is not applied to the treatment portion 41 of the high-frequency
knife 40, advance/retreat of the sheath 42 is executed at a set, relatively high speed
by the electrical advance/retreat apparatus 60. On the other hand, during an advance/retreat
operation of the sheath 42 in a treatment state where high frequency is applied to
the treatment portion 41 of the high-frequency knife 40, advance/retreat of the sheath
42 is executed by the electrical advance/retreat apparatus 60 at a speed that is lower
than the normal mode.
[0067] In addition, during driving of the electrical advance/retreat apparatus 60 according
to the respective modes in step S5, the control portion 20b judges whether the operation
lever 34 of the controller 30 is in an advance/retreat switch OFF state where the
operation lever 34 is no longer operated (S6).
[0068] In other words, a neutral state of the operation lever 34 of the controller 30 where
the operation lever 34 is neither tilted forward nor backward is a state where no
instruction signals for driving the electrical advance/retreat apparatus 60 are inputted
to the control portion 20b. In this state, the control portion 20b judges that the
advance/retreat switch is turned OFF. In addition, when the operation lever 34 of
the controller 30 is being continuously tilted forward or backwards, the control portion
20b judges that the advance/retreat switch is turned ON.
[0069] Furthermore, when the control portion 20b judges that the advance/retreat switch
is turned ON, the control portion 20b returns to step S2 to repeat the routine of
steps S2 to S6. On the other hand, when the control portion 20b judges that the advance/retreat
switch is turned OFF, the control portion 20b suspends output of the drive signal
of the electrical advance/retreat apparatus 60 that is an actuator and stops the electrical
advance/retreat apparatus 60 (S7), thereby stopping the advance/retreat of the sheath
42 of the high-frequency knife 40 and concluding the control flowchart shown in Fig.
3.
[0070] As seen, since the endoscopic system 1 according to the present embodiment controls
the advance/retreat speed of the sheath 42 of the high-frequency knife 40 during high-frequency
application that is a treatment state to be used for endoscopic submucosal dissection
(ESD) to a low speed, a configuration is realized that allows easier treatment operations
for dissection of living mucosa. In addition, since the endoscopic system 1 controls
the advance/retreat speed of the sheath 42 of the high-frequency knife 40 to a speed
that is higher than the treatment state when high-frequency from the high frequency
power supply 70 is not applied to the high-frequency knife 40, a configuration is
realized that allows the high-frequency knife 40 to be inserted to and retracted from
the treatment instrument insertion channel 14a of the endoscope 10 in a speedy manner,
and approaches to treatment target areas to be performed in a speedy manner.
[0071] Moreover, using the control apparatus 20, the user may set the advance/retreat speed
of the sheath 42 of the high-frequency knife 40 according to the above-described electrical
advance/retreat apparatus 60 to a desired arbitrary speed for each mode in the non-treatment
and treatment states.
(First Modification)
[0072] Next, a first modification of the present embodiment will be described below with
reference to Figs. 4 and 5. Note that the present modification uses a different treatment
instrument 40 for the endoscopic system 1, and now uses a high-frequency hemostatic
forceps that is used for arresting hemorrhage of living body tissue (hereinafter,
this treatment instrument shall be described as the high-frequency hemostatic forceps
40). Accordingly, like reference characters shall be used for the various configurations
of the endoscopic system 1 described above and descriptions thereof will be omitted.
Only different configurations and effects shall be described.
[0073] In addition, Figs. 4 and 5 show the first modification of the present invention,
in which: Fig. 4 is a diagram including a block display of a configuration of an endoscopic
system to which a high-frequency hemostatic forceps has been set; while Fig. 5 is
a flowchart illustrating control performed by a control apparatus of the endoscopic
system shown in Fig. 4.
[0074] As shown in Fig. 4, a high-frequency hemostatic forceps 40 is set to the endoscopic
system 1 according to the present modification. This high-frequency hemostatic forceps
40 is a treatment instrument for arresting hemorrhage of the living body tissue by
means of a treatment portion 41 to which high frequency is applied. Other configurations
of the high-frequency hemostatic forceps 40 are the same as the high-frequency knife
described above.
[0075] With the high-frequency hemostatic forceps 40, the treatment portion 41 is placed
against the hemorrhagic area, a high-frequency current is applied thereto, and the
tissue is coagulated and hemorrhage is arrested using heat generated locally at the
hemorrhagic area. The high-frequency hemostatic forceps 40 is used by gently pressing
the treatment portion 41 against the periphery of a blood vessel. In this case, the
hemostatic effect may be improved by pressing the treatment portion 41 against the
tissue for a period of time during high-frequency irradiation. In other words, the
treatment portion 41 of the high-frequency hemostatic forceps 40 in a treatment state
where high frequency is applied must be momentarily fixed at the position of the hemostasis
target.
[0076] For this reason, during advance/retreat operations of the high-frequency hemostatic
forceps 40, the endoscopic system 1 according to the present modification executes
the control example illustrated by the flowchart of Fig. 5 using the control apparatus
20. Similarly, in this case, a drive instruction signal from the operation lever 34
of the controller 30 acts as a trigger and causes the control apparatus 20 to perform
control based on the routine (steps) of the flowchart shown in Fig. 5.
[0077] More specifically, as shown in Fig. 5, the control apparatus 20 first reads treatment
instrument information of the high-frequency knife 40 inputted from the treatment
instrument ID read sensor 52a and stored in the treatment instrument ID internal IC
chip 49 at the treatment detection portion 20a. The treatment instrument information
is inputted from the treatment detection portion 20a to the control portion 20b (S11).
At this point, in the case where the treatment instrument is the high-frequency hemostatic
forceps 40, the control apparatus 20 performs control in accordance with the respective
steps of the flowchart shown in Fig. 3.
[0078] Then, the control portion 20b of the control apparatus 20 judges whether the high
frequency power supply 70 has been energized (S12). At this point, when the high frequency
power supply 70 is in an OFF state, the control portion 20b switches to a normal mode
(S13).
[0079] In this case, in the same manner as described above, the normal mode refers to a
normal advance/retreat mode in which the sheath 42 of the high-frequency hemostatic
forceps 40 advances/retreats at a preset, predetermined speed.
[0080] Next, in accordance with the normal mode, the control portion 20b drives the electrical
advance/retreat apparatus 60 that is an actuator (S14). More specifically, when a
transition is made to step S 13, the control portion 20b switches to the normal mode
and drives the electrical advance/retreat apparatus 60 in correspondence to a predetermined
speed at which the sheath 42 of the high-frequency hemostatic forceps 40 advances/retreats.
[0081] On the other hand, when the high frequency power supply 70 is in an ON state in step
S 12, the control portion 20b switches to a stop mode (S 15). In this case, the stop
mode refers to a mode in which the advance/retreat of the sheath 42 of the high-frequency
hemostatic forceps 40 is stopped. The control portion 20b then stops the electrical
advance/retreat apparatus 60 that is an actuator (S16).
[0082] In other words, when an ON signal is inputted from the switch of the controller 30,
the control portion 20b drives the high frequency power supply 70 so as to enable
high-frequency hemostasis of the living body tissue by the treatment portion 41 of
the high-frequency hemostatic forceps 40. In this state where an ON signal is inputted
from the switch of the controller 30, the control portion 20b switches to the stop
mode in step S 15.
[0083] In other words, the control portion 20b outputs drive signals or stops output thereof
to the motor that rotationally drives the roller 61 of the electrical advance/retreat
apparatus 60 according to the respective modes. As a result, according to the ON/OFF
state of the high frequency power supply 70, the advance/retreat of the sheath 42
of the high-frequency hemostatic forceps 40 is driven or stopped.
[0084] To elaborate, during a simple advance/retreat operation of the sheath 42 in a non-treatment
state where high frequency is not applied to the treatment portion 41 of the high-frequency
hemostatic forceps 40, advance/retreat of the sheath 42 is executed at a set speed
by the electrical advance/retreat apparatus 60. On the other hand, during an advance/retreat
operation of the sheath 42 in a treatment state where high frequency is applied to
the treatment portion 41 of the high-frequency hemostatic forceps 40, the driving
of the electrical advance/retreat apparatus 60 is stopped so that advance/retreat
of the sheath 42 cannot be performed by the electrical advance/retreat apparatus 60.
[0085] In addition, during driving or stopping of the electrical advance/retreat apparatus
60 according to the respective modes, the control portion 20b judges whether the operation
lever 34 of the controller 30 is in an advance/retreat switch OFF state where the
operation lever 34 is no longer operated (S 17).
[0086] In other words, in a neutral state of the operation lever 34 of the controller 30
where the operation lever 34 is neither tilted forward nor backward that is a state
where no instruction signals for driving the electrical advance/retreat apparatus
60 are inputted to the control portion 20b, the control portion 20b judges that the
advance/retreat switch is OFF. In addition, when the operation lever 34 of the controller
30 is being continuously tilted forward or backwards, the control portion 20b judges
that the advance/retreat switch is turned ON.
[0087] Furthermore, when the control portion 20b judges that the advance/retreat switch
is turned ON, the control portion 20b returns to step S12 to repeat the routine of
steps S12 to S17. On the other hand, if the control portion 20b judges that the advance/retreat
switch is turned OFF, the control portion 20b judges whether the electrical advance/retreat
apparatus 60 that is an actuator is stopped (S 18).
[0088] In this case, when the electrical advance/retreat apparatus 60 is driven or, in other
words, when a drive signal is being outputted to the electrical advance/retreat apparatus
60, the control portion 20b suspends output of the drive signal to the electrical
advance/retreat apparatus 60 and stops the electrical advance/retreat apparatus 60
(S 19). This stops the advance/retreat of the sheath 42 of the high-frequency hemostatic
forceps 40, thereby concluding the control flowchart in Fig. 5.
[0089] On the other hand, in step S 18, when the electrical advance/retreat apparatus 60
is stopped or, in other words, when a drive signal is not being outputted to the electrical
advance/retreat apparatus 60, the control portion 20b concludes the control flowchart
shown in Fig. 5 as is.
[0090] As a result of the above, when a treatment instrument of the high-frequency hemostatic
forceps 40 is used, the endoscopic system 1 according to the present embodiment performs
control to stop advance/retreat of the sheath 42 during high-frequency irradiation.
Therefore, the endoscopic system 1 is configured so that, in a treatment state where
high frequency is applied to the treatment portion 41 of the high-frequency hemostatic
forceps 40, hemostatic effects on the hemostasis target tissue area may be improved
by securely maintaining a state where the treatment portion 41 is pressed against
the tissue even when the operation lever 34 of the controller 30 is operated.
(Second Modification)
[0091] Next, a second modification of the present embodiment will be described below with
reference to Figs. 6 to 10. Note that the present modification also uses a different
treatment instrument 40 for the endoscopic system 1, and now uses a high-frequency
snare that is used for endoscopic polypectomy (hereinafter, this treatment instrument
shall be described as the high-frequency snare 40). Accordingly, like reference characters
shall be used for the various configurations of the endoscopic system 1 described
above and descriptions thereof will be omitted. Only different configurations and
effects shall be described.
[0092] Figs. 6 to 10 show the second modification of the present invention, in which: Fig.
6 is a diagram including a block display of a configuration of an endoscopic system
to which a high-frequency snare has been set; Fig. 7 is a cross sectional diagram
showing a configuration of a high-frequency snare; Fig. 8 is a flowchart illustrating
control performed by the control apparatus of the endoscopic system shown in Fig.
6; Fig. 9 is a diagram showing a state where the treatment portion of the high-frequency
snare is constricting a polyp; and Fig. 10 is a cross sectional diagram showing a
pressure sensor arranged on a sheath of the high-frequency snare.
[0093] As shown in Fig. 6, a high-frequency snare 40 is set to the endoscopic system 1 according
to the present modification. This high-frequency snare 40 is a treatment instrument
for removing polyps developed on living body tissue using a treatment portion 41 to
which high frequency is applied.
[0094] More specifically, with the high-frequency snare 40, as shown in Fig. 7, a treatment
portion 41 that is a snare wire made of metallic wire and which, in this case, has
an elliptic looped shape is connected to the distal end of an operation wire 43. This
metallic operation wire 43 is inserted into the sheath 42, and is pulled or relaxed
in accordance with the displacement of the slider 46 of the handle portion 44. In
addition, in order to apply high frequency outputted from the high frequency power
supply 70 to the treatment portion 41, the operation wire 43 is configured so as to
be electrically connected to the connector portion 44a of the handle portion 44.
[0095] In other words, in accordance with the advance/retreat of the operation wire 43 that
is interlocked with the slider 46, as shown in Fig. 7, the treatment portion 41 spreads
out in an elliptical shape during an open state. During a closed state, the treatment
portion 41 transforms itself into a shape that allows housing inside a distal end
portion of the sheath 42 and is introduced to or removed from the distal end portion
of the sheath 42. Moreover, in the present embodiment, a slide detection sensor 53b
inside the retaining box 53 detects an open/closed state of the treatment portion
41 of the high-frequency snare 40 from the advance/retreat displacement position of
the slider 46 of the handle portion 44.
[0096] This judgment of the open/closed state of the treatment portion 41 uses as a border
a position B, as shown in Fig. 7, at which the distal end of the treatment portion
41 is the same as the aperture surface of the sheath 42 in a state where the position
of the slider 46 is represented by the reference character b and the dashed line.
In other words, a state where the distal end of the treatment portion 41 protrudes
even if only slightly past the aperture face of the sheath 42 shall be considered
to be an open state of the treatment portion 41, while a state where the distal end
of the treatment portion 41 is housed inside the sheath 42 shall be considered to
be a closed state.
[0097] In addition, when the high-frequency snare 40 is in a state where the treatment portion
41 protrudes from the sheath 42, the displacement position a of the slider 46 represented
by the solid line in Fig. 7 is the maximum open state where the distal end of the
treatment portion 41 reaches position A. Furthermore, when the high-frequency snare
40 is in a state where the treatment portion 41 is housed in the sheath 42, the displacement
position c of the slider 46 represented by the dashed line in Fig. 7 is the maximum
closed state where the distal end of the treatment portion 41 is at position C.
[0098] According to the configuration described above, the endoscopic system 1 according
to the present modification executes the control example illustrated by the flowchart
of Fig. 8 using the control apparatus 20 during advance/retreat operations of the
high-frequency snare 40. Similarly, in this case, a drive instruction signal from
the operation lever 34 of the controller 30 acts as a trigger and causes the control
apparatus 20 to perform control based on the routine (steps) of the flowchart shown
in Fig. 8.
[0099] More specifically, as shown in Fig. 8, the control apparatus 20 first reads treatment
instrument information of the high-frequency snare 40 inputted from the treatment
instrument ID read sensor 52a and stored in the treatment instrument ID internal IC
chip 49 at the treatment detection portion 20a. The treatment instrument information
is inputted from the treatment detection portion 20a to the control portion 20b (S21).
At this point, in the case where the treatment instrument is the high-frequency snare
40, the control portion 20b of the control apparatus 20 performs control in accordance
with the respective steps of the flowchart shown in Fig. 8.
[0100] Then, based on the advance/retreat displacement position of the slider 46 of the
handle portion 44 obtained from the detected signal of the slide detection sensor
53b in the retaining box 53, the control portion 20b judges whether the treatment
portion 41 of the high-frequency snare 40 is in the open state (S22).
[0101] At this point, when the control portion 20b judges that the treatment portion 41
is in a closed state, the control portion 20b switches to a normal mode (S23).
[0102] In this case, the normal mode refers to a normal advance/retreat mode in which the
sheath 42 of the high-frequency snare 40 advances/retreats at a preset, predetermined
speed. In other words, a closed state of the treatment portion 41 of the high-frequency
snare 40 is simply a state where only an operation to advance/retreat the sheath 42
of the high-frequency snare 40 is performed.
[0103] On the other hand, when the control portion 20b judges in step S22 that the treatment
portion 41 is in an open state, the control portion 20b judges whether the high frequency
power supply 70 is energized (S24). At this point, when the high frequency power supply
70 is in an OFF state, the control portion 20b switches to low-speed mode (S25).
[0104] In this case, low-speed mode refers to a low-speed advance/retreat mode in which
the sheath 42 of the high-frequency snare 40 advances/retreats at a preset, predetermined
speed that is slower than the normal advance/retreat mode. In other words, when the
treatment portion 41 is in the open state, the advance/retreat speed of the sheath
42 is set to low speed.
[0105] Next, in accordance with each switched mode, the control portion 20b drives the electrical
advance/retreat apparatus 60 that is an actuator (S26). More specifically, when a
transition is made to step S23, the control portion 20b switches to the normal mode
and drives the electrical advance/retreat apparatus 60 in correspondence to a predetermined
speed at which the sheath 42 of the high-frequency snare 40 advances/retreats. On
the other hand, when a transition is made to step S25, the control portion 20b switches
to low-speed mode and drives the electrical advance/retreat apparatus 60 in correspondence
to a predetermined speed that is slower than the normal mode at which the sheath 42
of the high-frequency snare 40 advances/retreats.
[0106] In addition, when the high frequency power supply 70 is in an ON state in step S24,
the control portion 20b switches to stop mode (S27). Then, the control portion 20b
stops the electrical advance/retreat apparatus 60 that is an actuator (S28).
[0107] In other words, the control portion 20b outputs drive signals or stops output thereof
to the motor that rotationally drives the roller 61 of the electrical advance/retreat
apparatus 60 according to the respective modes. As a result, according to the ON/OFF
state of the high frequency power supply 70, the advance/retreat of the sheath 42
of the high-frequency snare 40 is driven or stopped. Therefore, when an ON signal
is inputted from the switch of the controller 30, the control portion 20b drives the
high frequency power supply 70 so as to enable constriction and dissection of living
body tissue at a high frequency by the treatment portion 41 of the high-frequency
snare 40.
[0108] Next, during driving of the electrical advance/retreat apparatus 60 according to
the respective modes, the control portion 20b judges whether the operation lever 34
of the controller 30 is in an advance/retreat switch OFF state where the operation
lever 34 is no longer operated (S29).
[0109] In other words, in the same manner as in the above-described first embodiment, a
neutral state of the operation lever 34 of the controller 30 where the operation lever
34 is neither tilted forward nor backward is a state where no instruction signals
for driving the electrical advance/retreat apparatus 60 are inputted to the control
portion 20b. In this state, the control portion 20b judges that the advance/retreat
switch is turned OFF. In addition, when the operation lever 34 of the controller 30
is being continuously tilted forward or backwards, the control portion 20b judges
that the advance/retreat switch is turned ON.
[0110] Furthermore, when the control portion 20b judges that the advance/retreat switch
is turned ON, the control portion 20b returns to step S22 to repeat the routine of
steps S22 to S28. On the other hand, if the control portion 20b judges that the advance/retreat
switch is turned OFF, the control portion 20b judges whether the electrical advance/retreat
apparatus 60 that is an actuator is stopped (S30).
[0111] In this case, when the electrical advance/retreat apparatus 60 is driven or, in other
words, when a drive signal is being outputted to the electrical advance/retreat apparatus
60, the control portion 20b suspends output of the drive signal to the electrical
advance/retreat apparatus 60 and stops the electrical advance/retreat apparatus 60
(S31). This stops the advance/retreat of the sheath 42 of the high-frequency snare
40, thereby concluding the control flowchart in Fig. 8.
[0112] On the other hand, in step S30, when the electrical advance/retreat apparatus 60
is stopped or, in other words, when a drive signal is not being outputted to the electrical
advance/retreat apparatus 60, the control portion 20b concludes the control flowchart
shown in Fig. 8 as is.
[0113] As a result, in a case where the treatment instrument of the high-frequency snare
40 is used in the endoscopic system 1, if the treatment portion 41 is in a closed
state, a polyp may be approached in a speedy manner at a normal displacement speed
of the sheath 42.
[0114] Additionally, in a state where an advance/retreat operation signal is being inputted
from the controller 30, as shown in Fig. 9, the displacement speed of the sheath 42
becomes slower during constriction of a polyp 100 which is an open state of the treatment
portion 41 of the high-frequency snare 40.
[0115] Furthermore, in a state where an advance/retreat operation signal is being inputted
from the controller 30, the displacement of the sheath 42 stops at a predetermined
position during polyp dissection upon which high frequency is applied to the treatment
portion 41 of the high-frequency snare 40.
[0116] Therefore, the endoscopic system 1 of the present embodiment is capable of recreating
advance/retreat speeds of the sheath 42 that improve operability in accordance with
various operation scenes of the high-frequency snare 40 by merely performing simple
operations of the controller 30. As a result, smooth polypectomy and easier treatment
are realized.
[0117] Moreover, as shown in Fig. 10, the control portion 20b of the control apparatus 20
may perform judgment of the open/closed state of the treatment portion 41 in the above-described
step S22 using a pressure sensor 42a provided on the sheath 42 of the high-frequency
snare 40.
[0118] More specifically, the pressure sensor 42a is disposed on the outer periphery of
the distal end portion of the sheath 42. One end of a signal cable, not shown, inserted
into the sheath 42 is connected to the pressure sensor 42a. The communication cable
has its the other end connected to the control apparatus 20, and transfers detected
signals from the pressure sensor 42a to the control apparatus 20.
[0119] In addition, when the treatment portion 41 of the high-frequency snare 40 is housed
in the sheath 42, if the longitudinal length is represented by L, the pressure sensor
42a is set so that the distal end position thereof is distanced by at least L/2 from
the distal end of the sheath 42.
[0120] The pressure sensor 42a detects the pressure with which the treatment portion 41
presses the inner face of the sheath 42, and outputs the result to the control apparatus
20 via the signal cable. In other words, the control portion 20b of the control apparatus
20 is capable of judging the closed state where the treatment portion 41 is housed
in the sheath 42 by the detection of a pressing force of the treatment portion 41
by the pressure sensor 42a.
[0121] That is, as shown in Fig. 9, when the operation wire 43 is extended by tension applied
to the operation wire 43 during constriction of the polyp 100, the control portion
20b recognizes a closed state even when a judgment based solely on the position of
the slider 46 results in an open state of the treatment portion 41.
[0122] As a result, by performing judgment based on detected values of the pressure sensor
42a, the control portion 20b is able to judge the closed state of the treatment portion
41 in a stable manner.
(Third Modification)
[0123] Next, a third modification of the present embodiment will be described below with
reference to Figs. 2 and 11. Moreover, for the present modification, the treatment
instrument used in the endoscopic system 1 is a high-frequency knife 40 (refer to
Fig. 2) in a manner similar to the above-described first embodiment, and the present
modification is an example of control performed by the control portion 20b of the
control apparatus 20. Therefore, the various configurations of the above-described
endoscopic system 1 are represented by like reference characters and descriptions
thereof will be omitted. Only different configurations and effects will be described.
Moreover, Fig. 11 is a third modification of the first embodiment, and shows a flowchart
illustrating control performed by the control apparatus of the endoscopic system.
[0124] The present example is a control example in which the displacement of the sheath
42 of the high-frequency knife 40 is regulated by the control apparatus 20 of the
endoscopic system 1.
[0125] First, a specified value (A) for regulating the displacement (X) by which the sheath
42 of the high-frequency knife 40 projects from the insertion portion 14 of the endoscope
10 during energization to the treatment portion 41 may be arbitrarily registered to
the treatment storage portion 20c that is built into the control apparatus 20 according
to the present embodiment. In other words, a user may register to the control apparatus
20, in advance, an arbitrarily specified value (A) of the length by which the sheath
42 of the high-frequency knife 40 to be used projects from the distal end portion
11 of the endoscope 10.
[0126] In addition, when the endoscope 10 is connected, the control apparatus 20 reads a
channel length and the like of the treatment instrument insertion channel 14a disposed
in the insertion portion 14 of the connected endoscope 10 from the endoscope ID internal
IC chip 26 built into the connector 25, and stores the length in the treatment storage
portion 20c. Then, the control apparatus 20 recognizes the position at which the sheath
42 of the high-frequency knife 40 reaches the distal end aperture 11a of the treatment
instrument insertion channel 14a of the distal end portion 11 of the endoscope 10
as 0 (zero).
[0127] In other words, the control apparatus 20 calculates a position at which the sheath
42 of the high-frequency knife 40 is advanced and inserted into the treatment instrument
insertion channel 14a by the electrical advance/retreat apparatus 60, and reaches
the distal end aperture 11a of the distal end portion 11, and sets that position to
0 (zero).
[0128] Then, based on the registered and set arbitrary specified value (A) and the position
0 (zero), the control portion 20b of the control apparatus 20 executes a control example
such as shown in Fig. 11. Similarly, in this case, a drive instruction signal from
the operation lever 34 of the controller 30 acts as a trigger and causes the control
apparatus 20 to perform control based on the routine (steps) of the flowchart shown
in Fig. 11.
[0129] More specifically, as shown in Fig. 11, the control apparatus 20 first reads treatment
instrument information of the high-frequency knife 40 inputted from the treatment
instrument ID read sensor 52a and stored in the treatment instrument ID internal IC
chip 49 at the treatment detection portion 20a. The treatment instrument information
is inputted from the treatment detection portion 20a to the control portion 20b (S41).
At this point, in the case where the treatment instrument is the high-frequency knife
40, the control portion 20b of the control apparatus 20 performs control in accordance
with the respective steps of the flowchart shown in Fig. 11.
[0130] Then, the control portion 20b of the control apparatus 20 judges whether the high
frequency power supply 70 is energized (S42). At this point, when the high frequency
power supply 70 is in an OFF state, the control portion 20b switches to the normal
mode (S43).
[0131] On the other hand, when the high frequency power supply 70 is in an ON state, the
control portion 20b judges whether the advance/retreat displacement X of the sheath
42 of the high-frequency knife 40 is not greater than 0 (zero), and whether the advance/retreat
displacement X is equal to or greater than a specified value A (X≥A) registered in
advance in the treatment storage portion 20c (S44). Moreover, for this judgment, the
control portion 20b compares the advance/retreat displacement X of the sheath 42 of
the high-frequency knife 40 that is calculated by the treatment detection portion
20a based on detected signals from the rotation detection sensor 62 built into the
electrical advance/retreat apparatus 60 with a specified value A that is registered
in the treatment storage portion 20c.
[0132] When the displacement X of the high-frequency knife 40 is not position 0 (zero) and
is less than the specified value A, the control portion 20b switches to low-speed
mode (S45).
[0133] As seen, in accordance with the respective modes including the normal mode and the
low-speed mode, the control portion 20b drives the electrical advance/retreat apparatus
60 that is an actuator (S46). More specifically, when a transition is made to step
S43, the control portion 20b switches to the normal mode and drives the electrical
advance/retreat apparatus 60 in correspondence to a predetermined speed at which the
sheath 42 of the high-frequency knife 40 advances/retreats. On the other hand, when
a transition is made to step S45, the control portion 20b switches to low-speed mode
and drives the electrical advance/retreat apparatus 60 in correspondence to a predetermined
speed that is slower than the normal mode at which the sheath 42 of the high-frequency
knife 40 advances/retreats. Subsequently, the control portion 20b makes a transition
to step S49, which will be described later.
[0134] In addition, when the displacement X of the sheath 42 of the high-frequency knife
40 is not greater than 0 (zero) or is equal to or more than the specified value A
in step S44, the control portion 20b switches to stop mode (S47). Furthermore, the
control portion 20b stops power supply to the electrical advance/retreat apparatus
60 that is an actuator even if an advance/retreat drive instruction signal is inputted
from the controller 30, and stops the advance/retreat of the sheath 42 of the high-frequency
knife 40 (S48). Subsequently, the control portion 20b makes a transition to step S49.
[0135] Moreover, at this point, when the displacement X of the sheath 42 of the high-frequency
knife 40 is at a position that is smaller than 0 (zero) or, in other words, when the
treatment portion 41 is at a position to be housed in the treatment instrument insertion
channel 14a, the control portion 20b is arranged to either turn high-frequency energization
OFF, or to stop power supply to the electrical advance/retreat apparatus 60.
[0136] Then, in step S49, during driving of the electrical advance/retreat apparatus 60
according to the respective modes, the control portion 20b judges whether the operation
lever 34 of the controller 30 is in an advance/retreat switch OFF state where the
operation lever 34 is no longer operated (S49).
[0137] At this point, when the control portion 20b judges that the advance/retreat switch
is turned ON, the control portion 20b returns to step S42 to repeat the routine of
steps S42 to S48. On the other hand, if the control portion 20b judges that the advance/retreat
switch is turned OFF, the control portion 20b judges whether the electrical advance/retreat
apparatus 60 that is an actuator is stopped (S50).
[0138] In this case, when the electrical advance/retreat apparatus 60 is driven or, in other
words, when a drive signal is being outputted to the electrical advance/retreat apparatus
60, the control portion 20b suspends output of the drive signal to the electrical
advance/retreat apparatus 60 and stops the electrical advance/retreat apparatus 60
(S51). This stops the advance/retreat of the sheath 42 of the high-frequency knife
40, thereby concluding the control flowchart in Fig. 11.
[0139] On the other hand, in step S50, when the electrical advance/retreat apparatus 60
is stopped or, in other words, when a drive signal is not being outputted to the electrical
advance/retreat apparatus 60, the control portion 20b concludes the control flowchart
shown in Fig. 11 as is.
[0140] As a result, in a case where the treatment instrument of the high-frequency knife
40 is used in the present modification, the endoscopic system 1 advances/retreats
the sheath 42 at low-speed mode during treatment of living body tissue upon which
a high-frequency current is applied to the treatment portion 41 when the displacement
X of the sheath 42 projected from the insertion portion 14 of the endoscope 10 is
more than 0 (zero) and lower than a set specified value A.
[0141] In addition, during treatment of living body tissue upon which a high-frequency current
is applied to the treatment portion 41, when the displacement X of the sheath 42 projected
from the insertion portion 14 of the endoscope 10 is equal to or greater than the
specified value A, the endoscopic system 1 switches to stop mode and stops the advance/retreat
of the sheath 42.
[0142] As a result, since the endoscopic system 1 does not advance the sheath 42 beyond
a preset specified value A even if an inadvertent operation of the controller 30 is
performed when a high-frequency current is being applied to the treatment portion
41, a configuration is realized that enables a position of dissection of living body
tissue using the high-frequency knife 40 to be set at intended positions. In addition,
since the endoscopic system 1 controls the sheath 42 of the high-frequency knife 40
to prevent the sheath 42 from being housed into the treatment instrument insertion
channel 14a of the endoscope 10 when a high-frequency current is being applied to
the treatment portion 41, damages to the treatment instrument insertion channel 14a
due to high frequency may be prevented.
(Second Embodiment)
[0143] Next, a second embodiment of the present invention will be described below with reference
to Figs. 12 and 13. Moreover, Figs. 12 and 13 show the second embodiment of the present
invention, in which: Fig. 12 is a diagram including a block display of a configuration
of an endoscopic system to which grasping forceps have been set; while Fig. 13 is
a flowchart illustrating control performed by the control apparatus of the endoscopic
system shown in Fig. 12.
[0144] A treatment instrument that does not perform treatment using high frequency power
is used in the endoscopic system 1 according to the present embodiment, and a case
will be described where, for example, grasping forceps (hereinafter described as the
grasping forceps 40) are used. Moreover, as well known, the grasping forceps 40 are
configured such that a cup-like treatment portion 41 opens/closes in accordance with
advance/retreat operations of a slider 46.
[0145] Furthermore, since the grasping forceps 40 according to the present embodiment are
not treatment instruments that use high-frequency, a high frequency power supply 70
is not shown in Fig. 12.
[0146] Moreover, in the present embodiment, since the treatment instruments 40 that are
used in the endoscopic system 1 are the grasping forceps 40, like reference characters
will be used for the various configurations of the above-described endoscopic system
1 and descriptions thereof will be omitted. Only different configurations and effects
shall be described.
[0147] Meanwhile, the open/closed state of the treatment portion 41 of the grasping forceps
40 is varied by the pulling/relaxing of the operation wire (having a similar configuration
as the high-frequency snare presented in the second modification of the first embodiment)
inserted into the sheath 42. In other words, the grasping forceps 40 is configured
so that the cup-like treatment portion 41 is opened/closed by forward and backward
advance/retreat operations of the slider 46 of the handle portion 44.
[0148] As seen, during advance/retreat operations of the grasping forceps 40, the endoscopic
system 1 according to the present embodiment to which the grasping forceps are installed
executes the control example illustrated by the flowchart of Fig. 13 using the control
apparatus 20. Similarly, in this case, a drive instruction signal from the operation
lever 34 of the controller 30 acts as a trigger and causes the control apparatus 20
to perform control based on the routine (steps) of the flowchart shown in Fig. 13.
[0149] In addition, as represented by the respective steps of the flowchart shown in Fig.
13, the present embodiment is a control example in which only the judgment performed
in step S62 differs from that of the first embodiment. In other words, while the control
apparatus 20 judges whether a high-frequency current is being applied to the treatment
portion 41 in step S2 of the first embodiment, in step S62 of the present embodiment,
the control apparatus 20 judges the open/closed state of the treatment portion 41
and performs control in accordance with the state.
[0150] Therefore, since the control apparatus 20 of the endoscopic system 1 performs in
step S61 and steps S63 to S67 shown in Fig. 13 the same controls as those in step
S1 and steps S3 to S7 of the first embodiment shown in Fig. 3, descriptions on such
controls shall be omitted from the following description for the sake of simplicity.
[0151] First, when treatment instrument information informing that the treatment instrument
to be used in step S61 are grasping forceps 40 is inputted (S61), the control portion
20b of the control apparatus 20 judges whether the treatment portion 41 of the grasping
forceps 40 is in an open state (S62). For this judgment, the control portion 20b judges
the open/closed state of the treatment portion 41 of the grasping forceps 40 by the
advance/retreat displacement position of the slider 46 of the handle portion 44 from
detected signals of the slide detection sensor 53b of the retaining box 53.
[0152] Then, when the control portion 20b judges that the treatment portion 41 of the grasping
forceps 40 is not an open state and is a closed state instead, the control portion
20b switches the advance/retreat speed of the sheath 42 to a normal mode that is a
normal speed (S63). On the other hand, when the control portion 20b judges that the
treatment portion 41 of the grasping forceps 40 is in an open state, the control portion
20b switches the advance/retreat speed of the sheath 42 to a low-speed mode that is
a predetermined speed slower than the normal mode (S64).
[0153] Next, in accordance with each switched mode, the control portion 20b drives the electrical
advance/retreat apparatus 60 that is an actuator (S65). More specifically, when a
transition is made to step S63, the control portion 20b switches to the normal mode
and drives the electrical advance/retreat apparatus 60 in correspondence to a predetermined
speed at which the sheath 42 of the grasping forceps 40 advances/retreats. On the
other hand, when a transition is made to step S64, the control portion 20b switches
to low-speed mode and drives the electrical advance/retreat apparatus 60 in correspondence
to a predetermined speed that is slower than the normal mode at which the sheath 42
of the grasping forceps 40 advances/retreats.
[0154] In other words, the control portion 20b variably outputs voltage to the motor that
rotationally drives the roller 61 of the electrical advance/retreat apparatus 60 according
to preset rotary speeds of the respective modes. As a result, the advance/retreat
speed of the sheath 42 of the grasping forceps 40 varies according to the open/closed
state of the grasping forceps 40.
[0155] As a result, in the endoscopic system 1, according to the present embodiment, since
the sheath 42 advances/retreats at a low speed in an open state of the treatment portion
41 of the grasping forceps 40, approachability to living body tissue that is the object
treatment area may be improved. In addition, since the endoscopic system 1 ensures
that the sheath 42 is not advanced/retreated at a relatively high normal speed in
an open state of the treatment portion 41 of the grasping forceps 40, inadvertent
retracting of the treatment portion 41 by the operator during housing to the treatment
instrument insertion channel 14a of the insertion portion 14 of the endoscope 10 may
be prevented. As a result, the endoscopic system 1 according to the present embodiment
is capable of preventing damage to the insertion portion 14 and the treatment instrument
insertion channel 14a by the treatment portion 41 of the grasping forceps 40.
(Third Embodiment)
[0156] Next, a third embodiment of the present invention will be described below with reference
to Figs. 14 and 15. Moreover, Figs. 14 and 15 show the third embodiment of the present
invention, in which: Fig. 14 is a diagram including a block display of a configuration
of an endoscopic system to which a rotating clip apparatus has been set; while Fig.
15 is a flowchart illustrating control performed by a control apparatus of the endoscopic
system shown in Fig. 14.
[0157] A treatment instrument that does not perform treatment using high frequency power
is also used in the endoscopic system 1 according to the present embodiment, and a
case will be described where, for example, a rotating clip apparatus (hereinafter
described as the rotating clip apparatus 40) that is a treatment apparatus is used.
Moreover, as well known, the rotating clip apparatus 40 is configured so that a treatment
portion 41 that is a surgical hemostatic clip rotates, and mucosa and blood vessels
in a living body are mechanically grasped or constricted by the treatment portion
41.
[0158] In addition, a spur gear 44b is disposed on the handle portion 44 of the rotating
clip apparatus 40. When the handle portion 44 of the rotating clip apparatus 40 is
disposed on the treatment instrument electrical operation apparatus 50, the gear 44b
meshes with the gear 56a of the motor 56 provided on a rear face side of the base
body 51 of the treatment instrument electrical operation apparatus 50.
[0159] In other words, during driving of the motor 56, the treatment instrument electrical
operation apparatus 50 transfers the rotation of the gear 56a to the gear 44b of the
rotating clip apparatus 40. As a result, the endoscopic system 1 according to the
present embodiment is configured so that the treatment portion 41 of the rotating
clip apparatus 40 rotates together with the sheath 42.
[0160] In addition, since the rotating clip apparatus 40 according to the present embodiment
is also a treatment instrument that does not use high-frequency, a high frequency
power supply 70 is not shown in Fig. 15.
[0161] Moreover, since the only difference of the present embodiment is that the treatment
instrument 40 to be used in the endoscopic system 1 is the rotating clip apparatus
40, like reference characters will be used for the various configurations of the endoscopic
system 1 according to the respective embodiments described above, and descriptions
thereof will be omitted. Only different configurations and effects shall be described.
[0162] As seen, during advance/retreat operations of the rotating clip apparatus 40, the
endoscopic system 1 according to the present embodiment to which the rotating clip
apparatus is installed executes the control example illustrated by the flowchart of
Fig. 15 using the control apparatus 20. Similarly, in this case, a drive instruction
signal from the operation lever 34 of the controller 30 acts as a trigger and causes
the control apparatus 20 to perform control based on the routine (steps) of the flowchart
shown in Fig. 15.
[0163] In addition, as represented by the respective steps of the flowchart shown in Fig.
15, the present embodiment is also a control example in which only the judgment performed
in step S72 differs from that of the first embodiment. In other words, while the control
apparatus 20 judges whether a high-frequency current is being applied to the treatment
portion 41 in step S2 of the first embodiment, in the present embodiment, the control
apparatus 20 judges in step S72 the rotating state of the treatment instrument 41
and performs control in accordance with the state.
[0164] Therefore, since the control apparatus 20 of the endoscopic system 1 performs in
step S71 and steps S73 to S77 shown in Fig. 15 the same controls as those in step
S1 and steps S3 to S7 of the first embodiment shown in Fig. 3, descriptions on such
controls shall be omitted from the following description for the sake of simplicity.
[0165] First, when treatment instrument information informing that the treatment instrument
to be used in step S71 is a rotating clip apparatus is inputted (S71), the control
portion 20b of the control apparatus 20 judges whether the treatment portion 41 of
the rotating clip apparatus 40 is in rotation (S72). For this judgment, the control
portion 20b judges whether the treatment portion 41 of the rotating clip apparatus
40 is in a rotating state based on the energization state of drive power to the motor
56 provided in the treatment instrument electrical operation apparatus 50.
[0166] Then, when the control portion 20b judges that the treatment portion 41 of the rotating
clip apparatus 40 is in a non-rotating state, the control portion 20b switches the
advance/retreat speed of the sheath 42 to a normal mode that is a normal speed (S73).
On the other hand, when the control portion 20b judges that the treatment portion
41 of the rotating clip apparatus 40 is in a rotating state, the control portion 20b
switches the advance/retreat speed of the sheath 42 to a low-speed mode that is a
predetermined speed slower than the normal mode (S74).
[0167] Next, in accordance with each switched mode, the control portion 20b drives the electrical
advance/retreat apparatus 60 that is an actuator (S75). More specifically, when a
transition is made to step S73, the control portion 20b switches to the normal mode
and drives the electrical advance/retreat apparatus 60 in correspondence to a predetermined
speed at which the sheath 42 of the rotating clip apparatus 40 advances/retreats.
On the other hand, when a transition is made to step S74, the control portion 20b
switches to low-speed mode and drives the electrical advance/retreat apparatus 60
in correspondence to a predetermined speed that is slower than the normal mode at
which the sheath 42 of the rotating clip apparatus 40 advances/retreats.
[0168] In other words, the control portion 20b variably outputs voltage to the motor that
rotationally drives the roller 61 of the electrical advance/retreat apparatus 60 according
to preset rotary speeds of the respective modes. As a result, the advance/retreat
speed of the sheath 42 of the rotating clip apparatus 40 varies according to the rotating
state of the rotating clip apparatus 40.
[0169] As a result, in the endoscopic system 1 according to the present embodiment, since
the sheath 42 advances/retreats at a low speed when the treatment portion 41 of the
rotating clip apparatus 40 is in a rotating state, approachability to a mucosal tissue
that is the object treatment area or a blood vessel on which hemostasis is to be performed
may be improved.
(Fourth Embodiment)
[0170] Next, a fourth embodiment of the present invention will be described below with reference
to Figs. 16 to 18. Figs. 16 and 17 show the fourth embodiment of the present invention,
in which: Fig. 16 is a perspective view showing a state where grasping forceps project
from the distal end portion of an endoscope; Fig. 17 is a diagram showing a display
on a monitor screen in the state shown in Fig. 16; and Fig. 18 is a flowchart illustrating
control performed by the control apparatus of an endoscopic system.
[0171] An endoscopic system 1 according to the present embodiment is an embodiment that
utilizes functions normally included in conventional endoscopic apparatuses. More
specifically, the control apparatus 20 that is a CCU is provided with a function for
recognizing luminescent points of reflected light in endoscopic images from the endoscope
10 as conditions of light modulation.
[0172] For example, as shown in Fig. 16, in a state where the treatment instrument, which,
in this case, is the grasping forceps 40, projects from the distal end portion 11
of the insertion portion 14 of the endoscope 10, the endoscopic image shows a luminescent
point R that is illuminating light reflecting off the sheath 42 of the grasping forceps
40 or the like, as shown in Fig. 17. Incidentally, reference character 11b in Fig.
16 denotes an image pickup window while reference character 11c denotes an illumination
window.
[0173] Light modulation performed by the control apparatus 20 on the image using the luminescent
point R as a reference results in excessively darkening the periphery of the luminescent
point R. Therefore, the control apparatus 20 recognizes the luminescent point R on
the image and exempts the luminescent point R from the conditions of light modulation
control. In other words, this light modulation control is a function that is also
included in conventional endoscopic apparatuses. Thus, the present embodiment is a
control example in which control is performed using this light modulation function.
[0174] Moreover, while a case where, for instance, grasping forceps (hereinafter described
as the grasping forceps 40) is used will be described for the endoscopic system 1
according to the present embodiment, it is obvious that the present embodiment is
applicable to any kind of treatment instrument.
[0175] As seen, during advance/retreat operations of the grasping forceps 40, the endoscopic
system 1 according to the present embodiment to which the grasping forceps 40 are
installed executes the control example illustrated by the flowchart of Fig. 18 using
the control apparatus 20. Similarly, in this case, a drive instruction signal from
the operation lever 34 of the controller 30 acts as a trigger and causes the control
apparatus 20 to perform control based on the routine (steps) of the flowchart shown
in Fig. 18.
[0176] In addition, as represented by the respective steps of the flowchart shown in Fig.
18, the present embodiment is also a control example in which only the judgment performed
in step S82 differs from that of the first embodiment. In other words, while the control
apparatus 20 according to the first embodiment judges whether a high-frequency current
is being applied to the treatment portion 41 in step S2, in the present embodiment,
the control apparatus 20 performs control by judging in step S82 the luminescent point
R reflecting off the treatment instrument 40 and judging whether the treatment instrument
40 projects from the distal end portion 11 of the endoscope 10.
[0177] Therefore, since the control apparatus 20 of the endoscopic system 1 performs in
step S81 and steps S83 to S87 shown in Fig. 18 the same controls as those in step
S1 and steps S3 to S7 of the first embodiment shown in Fig. 3, descriptions on such
controls shall be omitted from the following description for the sake of simplicity.
[0178] First, when treatment instrument information informing that the treatment instrument
to be used in step S81 are grasping forceps is inputted (S81), the control portion
20b of the control apparatus 20 judges whether the treatment portion 41 of the grasping
forceps 40 is projecting from the distal end portion 11 of the endoscope 10 (S82).
For this judgment, as described above, the control portion 20b judges whether the
treatment portion 41 of the grasping forceps 40 projects from the distal end portion
11 of the endoscope 10 according to the recognition of a luminescent point reflecting
off the sheath 42 and the like. Moreover, since the control apparatus 20 according
to the present embodiment is capable of controlling any kind of treatment instrument,
the inputting of treatment instrument information of step S81 need not be particularly
performed.
[0179] Then, when the control portion 20b judges that the grasping forceps 40 are in a non-projection
state with respect to the distal end portion 11 of the endoscope 10, the control portion
20b switches the advance/retreat speed of the sheath 42 to a normal mode that is a
normal speed (S83). On the other hand, when the control portion 20b judges that the
grasping forceps 40 project from the distal end portion 11 of the endoscope 10, the
control portion 20b switches the advance/retreat speed of the sheath 42 to a low-speed
mode that is a predetermined speed slower than the normal mode (S84).
[0180] Next, in accordance with each switched mode, the control portion 20b drives the electrical
advance/retreat apparatus 60 that is an actuator (S85). More specifically, when a
transition is made to step S83, the control portion 20b switches to the normal mode
and drives the electrical advance/retreat apparatus 60 in correspondence to a predetermined
speed at which the sheath 42 of the grasping forceps 40 advances/retreats. On the
other hand, when a transition is made to step S84, the control portion 20b switches
to low-speed mode and drives the electrical advance/retreat apparatus 60 in correspondence
to a predetermined speed that is slower than the normal mode at which the sheath 42
of the grasping forceps 40 advances/retreats.
[0181] In other words, the control portion 20b variably outputs voltage to the motor that
rotationally drives the roller 61 of the electrical advance/retreat apparatus 60 according
to preset rotary speeds of the respective modes. As a result, the advance/retreat
speed of the sheath 42 varies depending on whether the grasping forceps 40 are in
a treatment state where the grasping forceps 40 projects from the distal end portion
11 or a non-treatment state where the grasping forceps 40 are housed in the insertion
portion 14.
[0182] As seen, with the endoscopic system 1 according to the present embodiment, the sheath
42 advances/retreats at a relatively high speed until the grasping forceps 40 project
from the distal end portion 11 of the endoscope 10, and advances/retreats at a low
speed once the grasping forceps 40 project from the distal end portion 11 of the endoscope
10. In other words, with the endoscopic system 1 according to the present embodiment,
the grasping forceps 40 advances/retreats at a low speed once the grasping forceps
40 project from the distal end portion 11 of the endoscope 10 even in a case where
slippage occurs between the sheath 42 of the grasping forceps 40 and the roller 61
of the electrical advance/retreat apparatus 60 or in a case where the insertion portion
14 of the endoscope 10 is bended in a complicated fashion.
[0183] As a result, with the endoscopic system 1 according to the present embodiment, when
various treatment instruments, which was described above using grasping forceps as
an example, are in a non-treatment mode that is a state where the treatment instruments
are housed in the insertion portion 14 of the endoscope 10, the used treatment instrument
40 moves in a normal, relatively high advance/retreat speed and the time required
for feeding out and retracting may be reduced. On the other hand, in a treatment state
where the various treatment instruments 40 project from the distal end portion 11
of the endoscope 10, since the used treatment instrument 40 moves slower than the
normal advance/retreat speed, approachability to treatment areas in the body cavity
may be improved.
(Fifth Embodiment)
[0184] Next, a fifth embodiment of the present invention will be described below with reference
to Figs. 19 and 20. Figs. 19 and 20 show the fifth embodiment of the present invention,
in which: Fig. 19 is a cross sectional diagram showing a distal end portion of an
endoscope provided with an optical sensor and which shows a state where grasping forceps
are housed in a treatment instrument insertion channel; and Fig. 20 is a cross sectional
diagram showing a distal end of an endoscope provided with an optical sensor and showing
a state where grasping forceps project from the distal end.
[0185] Among the controls performed by the control apparatus 20 of the endoscopic system
1 described with respect to the fourth embodiment, the endoscopic system 1 according
to the present embodiment differs in the configuration of the sensor that judges in
step S82 whether the treatment portion 41 of the grasping forceps 40 projects from
the distal end portion 11 of the endoscope 10 as shown in Fig. 18. Accordingly, since
the present embodiment executes the control example shown in Fig. 18 that is performed
by the control apparatus 20 in the fourth embodiment, detailed descriptions of the
configurations and effects will be omitted. Only different portions shall be described
below.
[0186] To elaborate, as shown in Fig. 19, the distal end portion 11 of the insertion portion
14 of the endoscope 10 according to the present embodiment is provided with an optical
sensor comprising: a light emitting portion 81; and a light receiving portion 82 that
receives and detects light from the light emitting portion 81. The light emitting
portion 81 and the light receiving portion 82 are provided on the distal end portion
11 on a section protruding from the distal end face thereof, and are electrically
connected to the control apparatus 20 via a signal cable, not shown, inserted into
the insertion portion 14 of the endoscope 10. Moreover, the optical sensor comprising
the light emitting portion 81 and the light receiving portion 82 may be configured
to be detachable with respect to the distal end portion 11.
[0187] The endoscopic system 1 according to the present embodiment performs the judgment
(S82) by the control portion 20b of the control apparatus 20 on whether the treatment
portion 41 of the grasping forceps 40 projects from the distal end portion 11 of the
endoscope 10 using light from the light emitting portion 81 that is detected by the
light receiving portion 82.
[0188] In other words, as shown in Fig. 19, since light from the light emitting portion
81 illuminates the light receiving portion 82, the control portion 20b determines
that the treatment instrument, which, in this case, are the grasping forceps 40, is
in a state where the treatment instrument is housed in the treatment instrument insertion
channel 14a of the endoscope 10. On the other hand, as shown in Fig. 20, when light
from the light emitting portion 81 is not illuminating the light receiving portion
82, the control portion 20b determines that the treatment instrument, which, in this
case, are the grasping forceps 40, is in a state where the treatment instrument is
not housed in the treatment instrument insertion channel 14a of the endoscope 10.
Other effects are the same as those of the fourth embodiment.
(Sixth Embodiment)
[0189] Next, a sixth embodiment of the present invention will be described below with reference
to Figs. 21 to 24. Figs. 21 to 24 show the sixth embodiment of the present invention,
in which: Fig. 21 is a diagram showing a configuration of a distal end portion of
grasping forceps that are treatment instruments having a light reflective portion
provided at a rear end portion of a treatment portion thereof; Fig. 22 is a cross
sectional diagram showing a distal end portion of an endoscope provided with an optical
sensor and showing a state where grasping forceps project from the distal end portion;
Fig. 23 shows a modification and is a cross sectional diagram showing a distal end
of an endoscope provided with an optical sensor and showing a state where grasping
forceps project from the distal end portion; and Fig. 24 is a flowchart illustrating
control performed by a control apparatus of an endoscopic system.
[0190] In an endoscopic system 1 according to the present embodiment, the optical sensor
of the endoscopic system 1 described with respect to the fourth embodiment is provided
such that the positions of the light emitting portion and the light receiving portion
are in proximity to each other, and the optical sensor is of a type that detects reflections
of light emitted from the light emitting portion by the light receiving portion. Accordingly,
for the present embodiment, detailed descriptions of like configurations and effects
to the respective embodiments described above will be omitted, and only different
portions shall be described below. Moreover, while a treatment instrument will be
hereinafter described using, for example, grasping forceps 40, it is needless to say
that the present embodiment is also applicable to various treatment instruments.
[0191] As shown in Fig. 21, with the grasping forceps 40 that are the treatment instruments
of the present embodiment, a rear end portion of the treatment portion 41 that is
connected to the distal end of the sheath 42 is provided with an approximately tubular-
shaped reflector 47 having a reflecting surface 48 that is set to a predetermined
curvature r such that the circumferential diameter decreases in a rearward direction.
Moreover, the reflecting surface 48 of the reflector 47 is preferably mirror-finished.
[0192] In addition, the distal end portion 11 of the endoscope 10 according to the present
embodiment is provided with an optical sensor 83 in which the light emitting portion
and the light receiving portion are integrated. Therefore, since the endoscope 10
of the present embodiment is provided with only one optical sensor 83, the configuration
of the distal end portion 11 may be simplified in comparison with the fifth embodiment.
[0193] Moreover, as shown in Fig. 23, the optical sensor 83 may be configured so that the
light emitting portion and the light receiving portion face forward at a predetermined
angle so as to correspond to the reflecting surface 48 that is set to a predetermined
curvature r and which is formed on the reflector 47. As a result, since the optical
sensor 83 mostly responds to light reflected off the reflecting surface 48 of the
reflector 47, the optical sensor 83 may be prevented from coming close to the distal
end portion I 1 of the endoscope 10 and from responding to mucosa within the living
body which may rise above the distal end face.
[0194] The endoscopic system 1 of the present embodiment configured as described above may
either execute a control example by the control apparatus 20 in the same manner as
in the fourth embodiment or execute a control example such as that illustrated by
the flowchart of Fig. 24.
[0195] A control example of the flowchart shown in Fig. 24 and which is executed by the
control apparatus 20 will now be described in detail. In the case of the control example
shown in Fig. 24, when the optical sensor 83 detects reflected light from a passage
made by the reflecting surface 48 of the reflector 47 of the grasping forceps 40,
the control apparatus 20 is configured so as to count the number of detections N using
an internal counter, not shown. Similarly, in this case, a drive instruction signal
from the operation lever 34 of the controller 30 acts as a trigger and causes the
control apparatus 20 to perform control based on the routine (steps) of the flowchart
shown in Fig. 24.
[0196] More specifically, as shown in Fig. 24, the control apparatus 20 first reads treatment
instrument information of the grasping forceps 40 inputted from the treatment instrument
ID read sensor 52a and stored in the treatment instrument ID internal IC chip 49 at
the treatment detection portion 20a. The treatment instrument information is inputted
from the treatment detection portion 20a to the control portion 20b (S91).
[0197] Then, detected signals that are detected every time the reflector 47 of the grasping
forceps 40 passes the light detection position of the optical sensor 83 is inputted
to the control portion 20b from the optical sensor 83 (S92). In other words, when
light illuminated by the light emitting portion is reflected by the reflecting surface
48 formed on the reflector 47 of the grasping forceps 40, the optical sensor 83 outputs
a detected signal to the control apparatus 20.
[0198] At this point, the control portion 20b counts the number of passages N made by the
reflector 47 of the grasping forceps 40 by counting the detected signals of the optical
sensor 83 using an internal counter (S93).
[0199] Next, the control portion 20b judges whether the number of detected signals N of
the optical sensor 83 that have been inputted to the counter is 2 (N=2) (S94). If
the control portion 20b judges that the number of the detected signals is 2 (N=2),
the control portion 20b resets the internal counter (S95), and proceeds to step S97.
[0200] On the other hand, if the control portion 20b judges that the number of the detected
signals is not 2 (N≠2), the control portion 20b judges whether the number of detected
signals N by the optical sensor 83 and inputted to the counter is 0 (N=0) (S96). At
this point, if the number of detected signals N is 0 (N=0), the control portion 20b
advances to step S97.
[0201] Then, in step S97, the control portion 20b switches the sheath 42 of the grasping
forceps 40 to normal mode in which the sheath 42 advances/retreats at a preset predetermined
speed (S97). In addition, in step S96, when the control portion 20b judges that the
number of detected signals N is not 0 (N≠0), the control portion 20b switches the
sheath 42 of the grasping forceps 40 to low-speed mode in which the sheath 42 advances/retreats
at a predetermined speed that is slower than the normal mode (S98). Incidentally,
since the respective modes are described with respect to the respective embodiments
above, descriptions thereof will be omitted.
[0202] Next, in accordance with each switched mode, the control portion 20b drives the electrical
advance/retreat apparatus 60 that is an actuator (S99). More specifically, when a
transition is made to step S97, the control portion 20b switches to the normal mode
and drives the electrical advance/retreat apparatus 60 in correspondence to a predetermined
speed at which the sheath 42 of the grasping forceps 40 advances/retreats. On the
other hand, when a transition is made to step S98, the control portion 20b switches
to low-speed mode and drives the electrical advance/retreat apparatus 60 in correspondence
to a predetermined speed that is slower than the normal mode at which the sheath 42
of the grasping forceps 40 advances/retreats.
[0203] Next, during driving of the electrical advance/retreat apparatus 60 according to
the respective modes, the control portion 20b judges whether the operation lever 34
of the controller 30 is in an advance/retreat switch OFF state where the operation
lever 34 is no longer operated (S100).
[0204] In other words, in the same manner as in the above-described first embodiment, a
neutral state of the operation lever 34 of the controller 30 where the operation lever
34 is neither tilted forward nor backward is a state where no instruction signals
for driving the electrical advance/retreat apparatus 60 are inputted to the control
portion 20b. In this state, the control portion 20b judges that the advance/retreat
switch is turned OFF. In addition, when the operation lever 34 of the controller 30
is being continuously tilted forward or backwards, the control portion 20b judges
that the advance/retreat switch is turned ON.
[0205] Furthermore, when the control portion 20b judges that the advance/retreat switch
is turned ON, the control portion 20b returns to step S92 to repeat the routine of
steps S92 to S 100. In addition, in step S 100, when the electrical advance/retreat
apparatus 60 is stopped or, in other words, when a drive signal is not being outputted
to the electrical advance/retreat apparatus 60, the control portion 20b concludes
the control flowchart shown in Fig. 24 as is.
[0206] As described above, the endoscopic system according to the present embodiment is
also configured to include the effects of the respective embodiments. In addition,
with the endoscopic system 1 according to the present embodiment, by having the reflector
47 of the grasping forceps 40 that are the treatment instruments advance/retreat so
as to pass the detection position of the optical sensor 83 by arbitrary operations
of the controller 30, the operator is able to switch between the normal mode and the
low-speed mode.
(Seventh Embodiment)
[0207] Next, a seventh embodiment of the present invention will be described below with
reference to Figs. 25 to 27. Figs. 25 to 27 show the seventh embodiment of the present
invention, in which: Fig. 25 is a diagram showing a state prior to the removal of
living mucosa by a treatment portion of the biopsy forceps projecting from the distal
end of an endoscope; Fig. 26 is a diagram showing a state after the removal of living
mucosa by the treatment portion of the biopsy forceps; and Fig. 27 is a flowchart
illustrating control performed by a control apparatus of an endoscopic system.
[0208] In the present embodiment, the treatment instruments 40 to be used in the endoscopic
system 1 are biopsy forceps (hereinafter described as the biopsy forceps 40). The
present embodiment is a control example in which the advance/retreat displacement
of the sheath 42 of the biopsy forceps 40 is controlled by the control apparatus 20.
Accordingly, for the present embodiment as well, detailed descriptions of like configurations
and effects to the respective embodiments described above will be omitted, and only
different portions shall be described below.
[0209] Incidentally, as well known, the biopsy forceps 40 to be used in the endoscopic system
1 according to the present embodiment are for extracting living mucosa or living body
tissue by the opening and closing treatment portion 41.
[0210] Extraction of living mucosa (denoted by reference character 101 as shown in Figs.
25 and 26) using the biopsy forceps 40 is performed by the operator as shown in Figs.
25 and 26 by predetermined tilt operations of the operation lever 34 provided at the
operation instruction portion 33 of the controller 30.
[0211] To elaborate, as shown in Fig. 25, when feeding out the treatment portion 41 of the
biopsy forceps 40 of the distal end portion 11 of the endoscope 10 in a forward direction,
the operator tilts the operation lever 34 of the controller 30 forward. At the same
time, when opening the treatment portion 41 towards the living mucosa 101, the operator
tilt-operates the operation lever 34 in the direction displayed "open" that is displayed
on the operation instruction portion 33. Consequently, the treatment portion 41 of
the biopsy forceps 40 opens while moving forward together with the sent-out sheath
42.
[0212] Then, as shown in Fig. 26, when closing the treatment portion 41 of the biopsy forceps
40 to nip the living mucosa 101, the operator tilt-operates the operation lever 34
of the controller 30 in the direction displayed "open" that is displayed on the operation
instruction portion 33, and when the operator desires to simultaneously retract the
sheath 42, the operator simultaneously tilts the operation lever 34 backward. As a
result, the treatment portion 41 of the biopsy forceps 40 moves backward together
with the sheath 42 in a state where the living mucosa 101 is separated and nipped.
[0213] As this point where the living mucosa is being nipped, the living mucosa 101 may
be separated from the living body wall more easily by having the treatment portion
41 of the biopsy forceps 40 retreat at high speed. Therefore, in addition to the normal
mode and the low-speed mode of the respective embodiments described above, the endoscopic
system 1 according to the present embodiment is configured to be also switchable to
a biopsy mode that is a high-speed mode to be used during extraction of the living
mucosa 101.
[0214] Accordingly, the control apparatus 20 of the endoscopic system 1 according to the
present embodiment executes the control example of the flowchart shown in Fig. 27.
Accordingly, for the present embodiment as well, detailed descriptions of like configurations
and effects to the respective embodiments described above will be omitted, and only
different portions shall be described below.
[0215] A control example of the flowchart shown in Fig. 27 and which is executed by the
control apparatus 20 will now be described in detail. Moreover, in the case of the
control example shown in Fig. 27, switching to the biopsy mode may be performed by
the operator by arbitrary operations of the controller 30. This switching of modes
may be performed by, for example, so-called one-click or double-click switching where
the operation lever 34 of the controller 30 is pressed into the operation instruction
portion 33, or a switch for switching to biopsy mode may be provided on the controller
30.
[0216] First, a drive instruction signal from the operation lever 34 of the controller 30
similarly acts as a trigger and causes the control apparatus 20 to perform control
based on the routine (steps) of the flowchart shown in Fig. 27.
[0217] More specifically, when treatment instrument information informing that the treatment
instrument to be used in step S111 are biopsy forceps is inputted (S111), the control
portion 20b of the control apparatus 20 judges whether the treatment portion 41 of
the biopsy forceps 40 is in a closed state (S112). For this judgment, the control
portion 20b judges the open/closed state of the treatment portion 41 of the biopsy
forceps 40 by the advance/retreat displacement position of the slider 46 of the handle
portion 44 from detected signals of the slide detection sensor 53b of the retaining
box 53.
[0218] Then, when the control portion 20b judges that the treatment portion 41 of the biopsy
forceps 40 is not a closed state and is an open state instead, the control portion
20b switches the advance/retreat speed of the sheath 42 to the low-speed mode that
is a speed slower than the normal mode (S 113). On the other hand, when the control
portion 20b judges that the treatment portion 41 of the biopsy forceps 40 is in a
closed state, the control portion 20b judges whether a biopsy mode signal has been
inputted (S 114). At this point, if a biopsy mode signal has not been inputted, the
control portion 20b switches the advance/retreat speed of the sheath 42 to the normal
mode (S115).
[0219] Next, in accordance with each switched mode, the control portion 20b drives the electrical
advance/retreat apparatus 60 that is an actuator (S 116). More specifically, when
a transition is made to step S 113, the control portion 20b switches to low-speed
mode and drives the electrical advance/retreat apparatus 60 in correspondence to a
predetermined speed that is slower than the normal mode at which the sheath 42 of
the biopsy forceps 40 advances/retreats. On the other hand, when a transition is made
to step S 115, the control portion 20b switches to the normal mode and drives the
electrical advance/retreat apparatus 60 in correspondence to a predetermined speed
at which the sheath 42 of the biopsy forceps 40 advances/retreats.
[0220] Additionally, in step S114, when the control portion 20b judges that a biopsy mode
signal has been inputted, the control portion 20b switches to a biopsy mode (S 117).
In this case, the biopsy mode refers to a high-speed advance/retreat mode in which
the sheath 42 of the biopsy forceps 40 advances/retreats at a predetermined speed
that is faster than the preset normal mode.
[0221] Subsequently, the control portion 20b disables opening/closing operations of the
treatment portion 41 of the biopsy forceps 40 (S 118). In other words, the control
portion 20b does not output a drive signal to the retaining box 53 of the electrical
operation apparatus 50 even if an operation signal for changing to an open state is
inputted by an operation of the controller 30 from a closed state of the treatment
portion 41 of the biopsy forceps 40.
[0222] As a result, the closed state of the treatment portion 41 of the biopsy forceps 40
is maintained. In other words, when the biopsy mode is selected, a state where the
living mucosa 101 is nipped by the treatment portion 41 of the biopsy forceps 40 is
maintained. Therefore, the treatment portion 41 is prevented from opening when the
operator accidentally tilt-operates the operation lever 34 of the controller 30 in
a direction that changes the treatment portion 41 to an open state, thereby preventing
the operator from missing the nipped living mucosa 101.
[0223] Subsequently, in a state where opening/closing operations of the treatment portion
41 of the biopsy forceps 40 are still disabled, the control portion 20b drives the
electrical advance/retreat apparatus 60 that is an actuator only in the retreating
direction of the sheath 42 (S119). Therefore, unnecessary operations where the sheath
42 advances at high speed may be avoided when the operator accidentally tilt-operates
the operation lever 34 of the controller 30 in a forward advancing direction of the
sheath 42 during biopsy mode.
[0224] In other words, when the biopsy mode is selected, the closed state of the treatment
portion 41 of the biopsy forceps 40 is maintained, and only high-speed retreat of
the sheath 42 of the biopsy forceps 40 will be possible.
[0225] Next, during driving of the electrical advance/retreat apparatus 60 according to
the respective modes, the control portion 20b judges whether the operation lever 34
of the controller 30 is in an advance/retreat switch OFF state where the operation
lever 34 is no longer operated (S120).
[0226] Furthermore, when the control portion 20b judges that the advance/retreat switch
is turned ON, the control portion 20b returns to step S 112 to repeat the routine
of steps S 112 to S 119. On the other hand, when the control portion 20b judges that
the advance/retreat switch is turned OFF, the control portion 20b suspends output
of the drive signal of the electrical advance/retreat apparatus 60 that is an actuator
and stops the electrical advance/retreat apparatus 60 (S 121), thereby stopping the
advance/retreat of the sheath 42 of the biopsy forceps 40 and concluding the control
flowchart shown in Fig. 27.
[0227] As described above, a configuration of the endoscopic system 1 according to the present
embodiment that achieves favorable operability may be realized in which, when a treatment
instrument that extracts living mucosa 101 and the like, which, in this case are biopsy
forceps 40, is used, the sheath 42 advances/retreats at low speed in a state where
the treatment portion 41 is opened towards the living mucosa 101 to be extracted,
while the sheath 42 retreats at high speed when biopsy mode is selected in order to
separate the living mucosa 101 that is nipped by the treatment portion 41 in a speedy
manner. In addition, since the endoscopic system 1 according to the present embodiment
is unable to perform opening/closing operations of the treatment portion 41 and forward
displacement operations of the sheath 42 during an extraction of the living mucosa
101 by the treatment portion 41, the living mucosa 101 and the like may be extracted
in a secure manner.
(Eighth Embodiment)
[0228] Next, an eighth embodiment of the present invention will be described below with
reference to Figs. 28 and 29. Moreover, Figs. 28 and 29 show the eighth embodiment
of the present invention, in which: Fig. 28 is a diagram showing an overall configuration
of an endoscopic system to which a high-frequency knife has been set; while Fig. 29
is a flowchart illustrating control performed by the control apparatus of the endoscopic
system shown in Fig. 28.
[0229] As shown in Fig. 28, an endoscope 10 of an endoscopic system 1 according to the present
embodiment is configured so that a bending portion 12 of an insertion portion 14 is
electrically bent by operations of a track ball 16a provided at an operation portion
15. Incidentally, the endoscope 10 having such an electrical bending mechanism by
means of the track ball 16a is a conventional configuration. Therefore, a detailed
description thereof will be omitted. In addition, while the present embodiment will
be described using an example of the track ball 16a that bend-operates the bending
portion 12, the present embodiment is not limited to this example, and a bending operation
lever may be used instead.
[0230] As described, with the endoscopic system 1 according to the present embodiment, when
the endoscope 10 that electrically drives the bending portion 12 is used, the control
apparatus 20 executes the control example according to the respective steps of the
flowchart shown in Fig. 29. Other configurations of the endoscopic system 1 are the
same as the respective embodiments. Therefore, detailed descriptions of configurations
and effects that are the same as those of the respective embodiments described above
will be omitted, and only different portions shall be described below.
[0231] In addition, while the treatment instrument to be used in the present embodiment
will be described using the high-frequency knife 40 as an example, the present embodiment
is not limited to this example. Instead, the present embodiment is also applicable
to any treatment instrument that applies high frequency to the treatment portion 41.
[0232] Furthermore, with this endoscopic system 1, when a bending instruction signal for
bending the bending portion 12 of the endoscope 10 is inputted to the control apparatus
20, the input of the bending instruction signal acts as a trigger and causes the control
apparatus 20 to perform control based on the routine (steps) of the flowchart shown
in Fig. 29. In other words, when the track ball 16a of the endoscope 10 is operated
by the operator, the control apparatus 20 outputs a drive signal to an electrical
bending mechanism built into the endoscope 10 that causes the electrical bending mechanism
to drive bending of the bending portion 12 based on the operation state of the track
ball 16a. At this point, the control apparatus 20 executes a control example in accordance
with the respective steps of the flowchart shown in Fig. 29.
[0233] First, as shown in Fig. 29, the control apparatus 20 reads treatment instrument information
of the high-frequency knife 40 inputted from the treatment instrument ID read sensor
52a and stored in the treatment instrument ID internal IC chip 49 at the treatment
detection portion 20a. The treatment instrument information is inputted from the treatment
detection portion 20a to the control portion 20b (S131).
[0234] Then, the control portion 20b of the control apparatus 20 judges whether the high
frequency power supply 70 has been energized (S 132). At this point, when the high
frequency power supply 70 is in an OFF state, the control portion 20b switches to
the normal mode (S133). In this case, the normal mode refers to a normal bending mode
in which the bending portion 12 of the endoscope 10 is bent at a predetermined speed.
[0235] At this point, when the high frequency power supply 70 is in an ON state, the control
portion 20b switches to low-speed mode (S 134). In this case, low-speed mode refers
to a low-speed bending mode in which the bending portion 12 of the endoscope 10 is
bent at a predetermined speed that is slower than the normal mode.
[0236] Next, in accordance with each switched mode, the control portion 20b drives the electrical
bending mechanism that is an actuator in this case (S 135). More specifically, when
a transition is made to step S 133, the control portion 20b switches to the normal
mode and outputs a normal bending drive signal for performing bending in correspondence
to a predetermined speed to the electrical bending mechanism that drives the bending
portion 12 of the endoscope 10. On the other hand, when a transition is made to step
S 134, the control portion 20b switches to low-speed mode and outputs a low-speed
bending drive signal for performing bending in correspondence to a predetermined speed
that is slower than the normal mode to the electrical bending mechanism that drives
the bending portion 12 of the endoscope 10. In other words, the speed at which the
bending portion 12 of the endoscope 10 bends varies according to the ON/OFF state
of the high frequency power supply 70.
[0237] In addition, during driving of the electrical bending mechanism according to the
respective modes in step S135, the control portion 20b judges whether the current
state is a bending operation OFF state where the track ball 16a of the operation portion
15 of the endoscope 10 is no longer operated (S136).
[0238] In other words, a state where no operations are performed on the track ball 16a by
the operator is a state where instruction signals for driving the electrical bending
mechanism are not inputted to the control portion 20b. In this state, the control
portion 20b judges that bending operations are OFF. In addition, in a state where
the track ball 16a is being continuously operated, the control portion 20b judges
that bending operations are ON.
[0239] Furthermore, when the control portion 20b judges that bending operations are ON,
the control portion 20b returns to step S 132 to repeat the routine of steps S 132
to S 136. On the other hand, when the control portion 20b judges that the bending
operations are OFF, the control portion 20b suspends output of the drive signal of
the electrical bending mechanism that is an actuator and stops the electrical bending
mechanism (S 137), thereby stopping the advance/retreat of the bending portion 12
of the endoscope 10 and concluding the control flowchart shown in Fig. 29.
[0240] As seen, with the endoscopic system 1 according to the present embodiment, since
the bending displacement of the bending portion 12 of the endoscope 10 is performed
at low speed when high frequency is being applied to the treatment portion 41 of the
high-frequency knife 40, a configuration is realized in which dissection of living
mucosa may be performed in an easy manner. Consequently, the operator is able to accurately
perform dissection of target living mucosa.
[0241] Moreover, in addition to treatment instruments that use high frequency, various other
treatment instruments may be used under the control of the control apparatus 20 by
changing the judgment performed in step S132 with respect to the state where the treatment
portion 41 becomes active, and control may be performed so that the bending speed
of the bending portion 12 of the endoscope 10 is switched to low-speed mode.
(Reference Examples)
[0242] Reference examples of each endoscopic system 1 described above will be described
below.
(First Reference Example)
[0243] First, a first reference example will be described. Fig. 30 is a perspective view
showing a controller of an endoscopic system 1 and a control apparatus according to
the first reference example.
[0244] As shown in Fig. 30, a controller 30 according to the present reference example is
provided with two operation buttons 35 and 36. In addition, a main switch 28 is disposed
on a front panel of the control apparatus 20. The two operation buttons 35 and 36
are capable of issuing various operation instructions separately from the main switch
28 of the control apparatus 20.
[0245] For instance, the operation buttons 35 and 36 are configured so that one of the operation
buttons 35 and 36 is a controller activation switch while the other is a controller
stopping switch. In the case of this configuration, the controller 30 cannot be energized
or stopped unless the operator knowingly operates the operation buttons 35 and 36.
In other words, it is possible to knowingly initiate or stop output of operation instruction
signals from the controller 30 to the control apparatus 20.
[0246] Consequently, by setting the controller 30 to a stopped state when connecting the
controller 30 to the control apparatus 20 and the like, an instruction signal is not
outputted from the controller 30 to the control apparatus 20 even if the operation
lever 34 is inadvertently touched. Therefore, at the treatment instrument 40, operations
of the treatment portion 41 by the treatment instrument electrical operation apparatus
50 and advance/retreat movement of the sheath 42 by the treatment instrument electrical
advance/retreat apparatus 60 are not performed. As a result, erroneous operations
by the operator may be prevented and, in turn, failures, damages and the like of the
endoscopic system 1 and the treatment instrument 40 may be prevented.
[0247] In addition, the two operation buttons 35 and 36 may be configured so that one of
the two operation buttons 35 and 36 is an activation switch for the controller 30
and the other is a cancel switch that disables various switch operations of the control
apparatus 20.
[0248] In other words, by turning ON both the controller-side activation switch and the
cancel button, both the treatment instrument electrical operation apparatus 50 and
the treatment instrument electrical advance/retreat apparatus 60 of the endoscopic
system 1 may be driven solely by operations of the controller 30. In other words,
all operation instructions by the operation buttons on the control apparatus 20 side
are disabled.
[0249] Consequently, even when the various switches on the control apparatus 20 side are
erroneously operated, the treatment instrument electrical operation apparatus 50 and
the treatment instrument electrical advance/retreat apparatus 60 are not driven. As
a result, erroneous operations on the control apparatus 20 side may be prevented,
and the same effects as described above may be achieved.
(Second Reference Example)
[0250] Next, a second reference example will be described. Fig. 31 is a cross sectional
diagram showing a state where a controller is grasped by an operator according to
the second reference example.
[0251] As shown in Fig. 31, for the present reference example, the controller 30 is configured
so that the operation lever 34 of the operation instruction portion 33 is not enabled
unless a user such as an operator grasps the controller 30 with a hand H represented
by the dashed-two dotted line.
[0252] To elaborate, as shown in Fig. 31, the controller 30 is provided with a pair of electrodes
37 and 38 comprising bio-detection means that is touched by the hand H of the user
on, in this case, a rearward side on the same surface thereof as the operation instruction
portion 33. These electrodes 37 and 38 are disposed so as to be spaced by a predetermined
distance, and are respectively electrically connected to the operation instruction
portion 33.
[0253] By having the user grasp the controller 30 configured as described above, the hand
H of the user touches the respective electrodes 37 and 38, whereby the respective
electrodes 37 and 38 become conductive via the hand H that is a living body, and the
operation instruction portion 33 of the controller 30 is enabled. In other words,
the controller 30 is in a disabled state when not grasped by the user where instruction
signals are not outputted to the control apparatus 20 even when the operation lever
34 of the operation instruction portion 33 is tilt-operated.
[0254] According to such a configuration, since operations by the operation lever 34 of
the operation instruction portion 33 are enabled only when the controller 30 is securely
grasped by the user, operation signals are not outputted to the control apparatus
20 even if the controller 30 inadvertently touches something and the operation lever
34 is tilted. Moreover, an activation switch may be provided instead which switches
ON the functions of the endoscopic system 1 when the respective electrodes 37 and
38 of the controller 30 become conductive.
(Third Reference Example)
[0255] Next, a third reference example will be described. Fig. 32 is a cross sectional diagram
showing a controller provided with a limit switch according to the third reference
example, while Fig. 33 is a cross sectional diagram showing a state where an insertion
portion is inserted into the controller shown in Fig. 32.
[0256] As shown in Fig. 32, the controller 30 according to the present reference example
is provided below the operation instruction portion 33 thereof with a limit switch
39 that is scope detection means having a limit button 39a that protrudes into an
insertion hole of the insertion portion. In other words, as shown in Fig. 32, the
limit switch 39 of the controller 30 is turned off when the insertion portion 14 of
the endoscope 10 is not inserted, and when the insertion portion 14 of the endoscope
10 is inserted, the limit button 39a touches and is inserted into the insertion portion
14, thereby turning the limit switch 39 on.
[0257] Consequently, the controller 30 is arranged to be energized by having the limit switch
39 recognize the insertion of the insertion portion 14 that enables the operation
instruction portion 33 only in a state where the insertion portion 14 is inserted
to the controller 30. As a result, since the operation instruction portion 33 of the
controller 30 is enabled and is energized only when the insertion portion 14 of the
endoscope 10 is securely inserted into the controller 30, similar effects to the respective
reference examples described above may be achieved.
(Fourth Reference Example)
[0258] Next, a fourth reference example will be described. Fig. 34 is a perspective view
showing a state where a slider of a treatment instrument is mounted to a retaining
portion of a treatment instrument electrical operation apparatus provided with a limit
switch according to the fourth reference example; Fig. 35 is a cross sectional diagram
showing the retaining portion in a state where a slider is not mounted; Fig. 36 is
a cross sectional diagram for describing a state where a slider is mounted; and Fig.
37 is a cross sectional diagram showing a state where a slider is mounted to the retaining
portion.
[0259] As shown in Fig. 34, in the present reference example, a limit switch 55c that detects
the mounting of a slider 46 slideably set on a handle portion 44 of the treatment
instrument 40 is provided on a retaining portion 55a of the treatment instrument electrical
operation apparatus 50.
[0260] The retaining portion 55a comprises a rotary plate body 55b rotatably mounted to
a lateral wall portion by a shaft 55e. A limit switch 55c having a limit button 55d
is provided on a wall portion on the side to which the rotary plate body 55b is provided.
The limit switch 55c is a switch for turning ON/OFF the controller 30.
[0261] Moreover, as shown in Fig. 35, the own weight of the rotary plate body 55b causes
the rotary plate body 55b to assume a toppled horizontal state. In addition, an elastic
member such as a spring may be provided on a lateral wall portion of the retaining
portion 55a so that the rotary plate body 55b assumes the toppled horizontal state.
[0262] As seen, in the course of mounting the slider 46 of the treatment instrument 40 to
the retaining portion 55a, as shown in Fig. 36, the slider 46 is mounted into the
retaining portion 55a while, in this case, pushing up the rotary plate body 55b. As
shown in Fig. 37, when the slider 46 is completely mounted to the retaining portion
55a, the rotary plate body 55b that is pushed up causes the limit button 55d of the
limit switch 55c to sink so that the limit switch 55c is turned ON.
[0263] An activation state that is an operable state where the operation instruction portion
33 of the controller 30 is enabled is realized only when the limit switch 55c is turned
ON. In other words, when the slider 46 of the treatment instrument 40 is mounted to
the retaining portion 55a, operations of the treatment instrument electrical operation
apparatus 50 and the treatment instrument electrical advance/retreat apparatus 60
by the controller 30 are enabled, and when the slider 46 of the treatment instrument
40 is not mounted to the retaining portion 55a, operations of the treatment instrument
electrical operation apparatus 50 and the treatment instrument electrical advance/retreat
apparatus 60 by the controller 30 are disabled.
[0264] According to such a configuration, even when the operation lever 34 of the operation
instruction portion 33 of the controller 30 is tilt-operated when replacing the treatment
instrument 40, operations of the treatment instrument electrical operation apparatus
50 and the treatment instrument electrical advance/retreat apparatus 60 are disabled
unless the slider 46 of the treatment instrument 40 is securely mounted to the retaining
portion 55a. As a result, the treatment instrument electrical operation apparatus
50 and the treatment instrument electrical advance/retreat apparatus 60 are not driven
even in cases of attachment deviation of the slider 46 and inadvertent, erroneous
operations when replacing the treatment instrument 40. Consequently, the configuration
of the present reference example achieves effects similar to the respective reference
examples.
(Fifth Reference Example)
[0265] Next, a fifth reference example will be described. Fig. 38 is a configuration diagram
showing a controller, a treatment instrument electrical operation apparatus and a
treatment instrument changer according to the fifth reference example.
[0266] For the present reference example, a description is provided on a treatment instrument
changer 90 that is an automatic changer capable of automatically changing a plurality
of various treatment instruments (A to E) 40 for the treatment instrument electrical
operation apparatus 50 by means of a treatment instrument changing-over switch 35a
provided on the controller 30.
[0267] In addition, a control portion 57 that is electrically connected to the controller
30, and a changer operation detection portion 58 are built into the treatment instrument
electrical operation apparatus 50. Furthermore, the treatment instrument changer 90
has, for instance, an array of various treatment instruments (A to E) 40 respectively
having different treatment functions, and changes, while sliding, the treatment instruments
(A to E) 40 that are selected by the treatment instrument electrical operation apparatus
50 so as to be operable.
[0268] Additionally, the changer operation detection portion 58 detects changing operations
of the treatment instruments (A to E) 40 by the treatment instrument changer 90 or,
in other words, whether the treatment instrument changer 90 is driven or stopped.
[0269] To elaborate, when the various treatment instruments (A to E) 40 are being changed
and the treatment instrument changer 90 is being driven, the changer operation detection
portion 58 outputs a changer ON signal to the control portion 57. In response, the
control portion 57 disables the treatment instrument changing-over switch 35a of the
controller 30.
[0270] On the other hand, when the various treatment instruments (A to E) 40 are not being
changed and the treatment instrument changer 90 is stopped, the changer operation
detection portion 58 outputs a changer OFF signal to the control portion 57. In response,
the control portion 57 enables the treatment instrument changing-over switch 35a of
the controller 30.
[0271] Accordingly, even when the treatment instrument changing-over switch 35a of the controller
30 is erroneously turned ON during driving of the treatment instrument changer 90,
the treatment instrument electrical operation apparatus 50 slides an originally selected
treatment instrument 40 to an operable condition, and the treatment instrument 40
is set to a predetermined position in the treatment instrument electrical operation
apparatus 50. In other words, even when the treatment instrument changing-over switch
35a of the controller 30 is inadvertently operated, the slide movement of the treatment
instrument changer 90 is regulated until the originally selected treatment instrument
40 is set to the treatment instrument electrical operation apparatus 50.
[0272] As a result, the selected treatment instrument 40 is securely set in the treatment
instrument electrical operation apparatus 50, and damages to the treatment instrument
40 due to inadvertent slide movement of the treatment instrument changer 90 may be
prevented.
[0273] Moreover, two functions for activating the treatment instrument changer 90 and changing
the entire controller 30 to a drive-disabled state through operations of the treatment
instrument changing-over switch 35a of the controller 30 may be provided. As a result,
detection by the changer operation detection portion 58 may be simplified.
[0274] Furthermore, after the treatment instrument changing-over switch 35a of the controller
30 is turned ON, the controller 30 may be changed to a stopped state where the functions
of the controller 30 are disabled for a period of time sufficient for the treatment
instrument 40 to be securely set by the treatment instrument changer 90 to the treatment
instrument electrical operation apparatus 50, and after the lapse of the controller
non-active time, the controller 30 may automatically be restored to a driven state
where the functions of the controller are enabled. As a result, the changer operation
detection portion 58 is no longer required and a simple configuration is realized.
[0275] The invention described above is not limited to the respective embodiments, and various
modifications may be achieved in the implementation phase of the invention without
departing from the scope of the invention. In addition, each embodiment includes inventions
of various stages, and various inventions may be extracted according to appropriate
combinations of a plurality of disclosed constituent features.
[0276] For example, even when several constituent features are deleted from all constituent
features shown in the respective embodiments, in the event that advantageous effects
described in relevant sections herein may be achieved with respect to problems to
be solved by the invention, a configuration from which such constituent features are
deleted may be extracted as an invention.
[0277] Having described the preferred embodiments of the invention referring to the accompanying
drawings, it should be understood that the present invention is not limited to those
precise embodiments and various changes and modifications thereof could be made by
one skilled in the art without departing from the spirit or scope of the invention
as defined in the appended claims.